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Percutane schroeffixatie voor osteoporotische sacrumfracturen bij oudere patiënten

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Nederlands Tijdschrift voor Traumachirurgie

Samenvatting

Een sacrumfractuur na een laagenergetisch trauma met een voorste bekkenringfractuur dat wordt gemist, kan zeer moeizame mobilisatie tot gevolg hebben of mobilisatie onmogelijk maken. In dit artikel beschrijven wij onze ervaringen met percutane sacro-iliacale schroeffixatie bij twee oudere patiënten met (gemiste) osteoporotische sacrumfracturen. Wij concluderen dat een ogenschijnlijk ‘geïsoleerde’ voorste bekkenringfractuur ook bij oudere patiënten nauwgezette analyse verdient naar een eventuele begeleidende achterste bekkenringfractuur, vooral bij pijn ter plaatse van het sacrum of laag in de onderrug. Bij aanwezigheid van een sacrumfractuur zou bij zorgvuldig geselecteerde patiënten tijdige percutane SI-schroeffixatie overwogen moeten worden om vroege mobilisatie te bevorderen.

Abstract

In older patients, pubic rami fractures resulting from low-impact falls are generally considered to be stable and treated non-operatively. An associated sacral fracture is easily missed on plain radiography but can result in debilitating pain. The objective of this report is to present our experience with percutaneous sacro-iliac screw fixation in two elderly patients with (missed) osteoporotic sacral fractures. We conclude that ‘isolated’ pubic rami fractures in elderly patients should prompt careful investigation to rule out an associated sacral fracture particularly in patients with lower back or sacral pain. In the presence of a sacral fracture, early percutaneous sacro-iliac screw fixation to allow rapid mobilization should be considered in selected patients.

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Authors and Affiliations

  1. afdeling Traumachirurgie, Erasmus Medisch Centrum, Rotterdam, The Netherlands

    D.O. Verbeek

  2. afdeling Heelkunde, Medisch Centrum Alkmaar, Alkmaar, The Netherlands

    K.J. Ponsen

Authors
  1. D.O. Verbeek
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  2. K.J. Ponsen
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Additional information

1 traumachirurg, afdeling Traumachirurgie, Erasmus Medisch Centrum, Rotterdam

2 traumachirurg, afdeling Heelkunde, Medisch Centrum Alkmaar, Alkmaar

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Verbeek, D., Ponsen, K. Percutane schroeffixatie voor osteoporotische sacrumfracturen bij oudere patiënten. Ned Tijdschr Traumachir 24, 9–12 (2016). https://doi.org/10.1007/s12506-016-0033-5

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  • DOI: https://doi.org/10.1007/s12506-016-0033-5

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