• K Käch and O Trentz.
• Departement Chirurgie, Universitätsspital Zürich.
• Unfallchirurg. 1994 Jan 1;97(1):28-38.

AbstractThe sacroiliac region is the link through which the weight of the trunk is transmitted to the legs and a region frequently indicated by patients as the site of back pain. Sacral fractures often remain undiagnosed and untreated and frequently result in neurologic symptoms and deficits. Since a systematic approach is used to analyse the pelvic ring fractures with CT scans, the surgical management of sacral fractures had become a focus of interest. Stabilization is important for survival of the patient and may improve the long-term functional results of treatment of such injuries. Specific treatments aimed at neurologic problems are available and may allow the patient functional recovery. Previous attempts to achieve internal fixation for sacral stabilization have used lag screws, sacral bars and plates in a compression mode. We present a new type of stabilization for vertically unstable sacral fractures in zones II and III (Denis). The aim of our suggested stabilization is a stable fixation without compression on the fracture side to protect the neural structures. We perform a transfixation from L5 to the pelvic rim with an internal fixator. Our instrumentation allows decompression (fracture reposition, sacral laminectomy, sacral foraminotomy) of the neural structures and stable fixation without compression. Five multiply traumatized patients with sacral fractures as a component of vertical shear injury of the pelvis had the sacroiliac region stabilized with the internal fixator. The preliminary results are presented.

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