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Minimally invasive surgical treatment using ‘iliac pillar’ screw for isolated iliac wing fractures in geriatric patients: a new challenge

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Abstract

Purpose

There have been no prior case series of isolated iliac wing fracture (IIWF) due to low-energy trauma in geriatric patients in the literature. The aim of this study was to describe the characteristics of IIWF in geriatric patients, and to present a case series of IIWF in geriatric patients who underwent our minimally invasive screw fixation technique named ‘iliac pillar screw fixation’.

Materials and methods

We retrospectively reviewed six geriatric patients over 65  years old who had isolated iliac wing fracture treated with minimally invasive screw fixation technique between January 2006 and April 2016.

Results

Six geriatric patients received iliac pillar screw fixation for acute IIWFs. The incidence of IIWFs was approximately 3.5% of geriatric patients with any pelvic bone fractures. The main fracture line exists in common; it extends from a point between the anterosuperior iliac spine and the anteroinferior iliac spine to a point located at the dorsal 1/3 of the iliac crest whether fracture was comminuted or not. Regarding the Koval walking ability, patients who underwent iliac pillar screw fixation technique tended to regain their pre-injury walking including one patient in a previously bedridden state. The visual analog scale score for pain at the last follow-up was quite satisfactory. Union was achieved in all patients at the last follow-up.

Conclusions

Geriatric patients can have a form of IIWF caused by low-energy trauma that is a type of fragility fracture of the pelvis. Because subsequent deterioration of their walking status followed by a long period of non-weight bearing in geriatric patients could be as threatening as the fracture itself, the treatment paradigm for IIWF due to low-energy trauma in geriatric patients should differ from that due to high-energy trauma in most patients. In these types of fractures, minimally invasive surgical management that includes iliac pillar screw fixation can lead to good outcomes.

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References

  1. Switzer JA, Nork SE, Routt ML Jr. Comminuted fractures of the iliac wing. J Orthop Trauma. 2000;14:270–6.

    Article  CAS  PubMed  Google Scholar 

  2. Abrassart S, Stern R, Peter R. Morbidity associated with isolated iliac wing fractures. J Trauma. 2009;66:200–3.

    Article  PubMed  Google Scholar 

  3. Tim D. White PAF. The human bone manual. Amsterdam: Elsevier Science; 2005.

    Google Scholar 

  4. Koval KJ, Skovron ML, Aharonoff GB, Meadows SE, Zuckerman JD. Ambulatory ability after hip fracture. A prospective study in geriatric patients. Clin Orthop Relat Res. 1995;310:150–9.

    Google Scholar 

  5. Cole PA, Jamil M, Jacobson AR, Hill BW. “The Skiver Screw”: a useful fixation technique for iliac wing fractures. J Orthop Trauma. 2015;29:e231–e234.

    Article  Google Scholar 

  6. Ayalon O, Schwarzkopf R, Marwin SE, Zuckerman JD. Iliac wing insufficiency fractures as unusual postoperative complication following total hip arthroplasty—a case report. Bull Hosp Jt Dis. 2013;71:301–4.

    Google Scholar 

  7. Chary-Valckenaere I, Blum A, Pere P, Grigon B, Pourel J, Gaucher A. Insufficiency fractures of the ilium. Rev Rhum Engl Ed. 1997;64:542–8.

    CAS  PubMed  Google Scholar 

  8. Rommens PM, Hofmann A. Comprehensive classification of fragility fractures of the pelvic ring: recommendations for surgical treatment. Injury. 2013;44:1733–44.

    Article  PubMed  Google Scholar 

  9. Lee SW, Kim WY, Koh SJ, Kim YY. Posterior locked lateral compression injury of the pelvis in geriatric patients: an infrequent and specific variant of the fragility fracture of pelvis. Arch Orthop Trauma Surg. 2017;137:1207–18.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Yong-Woo Kim, Sang-Heon Lee and Kyong-Jun Kim for their help in correcting English grammar for this article.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea

    Weon-Yoo Kim, Se-Won Lee, Ki-Won Kim & Soon-Yong Kwon

  2. Department of Orthopedic Surgery, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, 34943, Republic of Korea

    Weon-Yoo Kim

  3. Department of Orthopedic Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea

    Se-Won Lee & Ki-Won Kim

  4. Department of Orthopedic Surgery, College of Medicine, St. Paul’s Hospital, The Catholic University of Korea, Seoul, 02559, Republic of Korea

    Soon-Yong Kwon

  5. Department of Orthopedic Surgery, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, 16247, Republic of Korea

    Yeon-Ho Choi

Authors
  1. Weon-Yoo Kim
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  2. Se-Won Lee
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  3. Ki-Won Kim
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  4. Soon-Yong Kwon
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  5. Yeon-Ho Choi
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Corresponding author

Correspondence to Se-Won Lee.

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The authors declare that they have no conflict of interest.

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Kim, WY., Lee, SW., Kim, KW. et al. Minimally invasive surgical treatment using ‘iliac pillar’ screw for isolated iliac wing fractures in geriatric patients: a new challenge. Eur J Trauma Emerg Surg 45, 213–219 (2019). https://doi.org/10.1007/s00068-018-1046-0

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  • DOI: https://doi.org/10.1007/s00068-018-1046-0

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