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Iliosacral Screw Fixation with Cement Augmentation

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Fragility Fractures of the Pelvis

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Abstract

Cement augmentation of iliosacral screws is a novel technique to treat sacral insufficiency fractures in a geriatric population. Non- or minimally displaced sacral fractures are suitable for this technique. Prior to screw insertion, CT-evaluation is required in order to find and plan the correct corridor for the screws. Consecutively, special cannulated screws with side perforations near to the screw tip are implanted. If the surgeon has the impression of poor screw anchorage in the osteoporotic sacrum, 2–3 mL PMMA-based bone cement is injected through the screw. This leads to improved screw anchorage, may allow full weight bearing and reduces secondary screw loosening. Own data from an in vitro biomechanical study suggests that cement augmentation significantly increases the number of cycles to failure at the screw tip, but does not affect the overall construct stability. Significant pain relief and early patient mobilization have been perceived in our patients. Multi-center based clinical experience is lacking so far. Further clinical and biomechanical work is needed to confirm our preliminary data.

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Author information

Authors and Affiliations

  1. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer Campus 1, 48149, Münster, Germany

    Michael Raschke M.D. & Thomas Fuchs M.D.

  2. Department of Trauma and Reconstructive Surgery, Vivantes Clinics, Aroser Allee 72-76, 13407, Berlin, Germany

    Thomas Fuchs M.D.

Authors
  1. Michael Raschke M.D.
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  2. Thomas Fuchs M.D.
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Correspondence to Michael Raschke M.D. .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Traumatology, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany

    Pol Maria Rommens

  2. Department of Traumatology and Orthopaedics, Westpfalz-Clinics Kaiserslautern, Kaiserslautern, Germany

    Alexander Hofmann

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Raschke, M., Fuchs, T. (2017). Iliosacral Screw Fixation with Cement Augmentation. In: Rommens, P., Hofmann, A. (eds) Fragility Fractures of the Pelvis. Springer, Cham. https://doi.org/10.1007/978-3-319-66572-6_12

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  • DOI: https://doi.org/10.1007/978-3-319-66572-6_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66570-2

  • Online ISBN: 978-3-319-66572-6

  • eBook Packages: MedicineMedicine (R0)

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