Search results for "Ala of sacrum"
showing 4 items of 4 documents
Personality of Fragility Fractures of the Pelvis
2017
The personality of pelvic fractures in the elderly differs in many ways from pelvic ring lesions in adults. Only high-energy trauma leads to pelvic ring disruptions. Concomitant lesions of the soft tissues occur frequently. In the elderly, low-energy falls are the rule. The most important symptom is pain, which restricts mobility. Hemodynamic instability in fragility fractures of the pelvis is rare. Emergency stabilization with pelvic binders or sheets, C-clamping or emergency external fixation are not needed. Arteriography and selective embolization is only recommended in the rare patients, who develop an active arterial bleeding due to the pelvic fracture. Especially patients, who are tre…
Transsacral Bar Osteosynthesis
2017
Uni- or bilateral sacral ala fractures in elderly persons may cause significant disability and result in non-union, if treated non-surgically. Transsacral positioning bar osteosynthesis provides the advantages of a minimally invasive approach yet reducing the risk of implant loosening. A threaded 6 mm bar is inserted through the posterior part of the ilium and the SI-joint, and advanced through the center of the S1 vertebral body towards the opposite posterior ilium. Washers and nuts are placed and tightened on both ends of the bar providing moderate compression of the vertical fracture planes in the sacrum. The stability of fixation does not depend on the bone mineral density of the sacrum…
Bone Mass Distribution in the Sacrum
2017
The trabecular architecture and bone mass distribution of each bone follows biomechanical principles and is an adaption to the stress exhibited during lifetime. In patients with osteoporosis, the bone mass decreases and the bone microarchitecture changes. A distinct bone mass distribution in non-osteoporotic and osteoporotic individuals is demonstrated using statistical modelling in the sacrum. The authors studied the sacral bone mass distribution using a 3D statistical model based on clinical CT scans of 92 Europeans. In the group with worse general bone mass (less than 100 Houndsfeld Units (HU) measured in the body of L5), there were large areas of negative HU in the sacral alae. These “a…
Iliosacral Screw Osteosynthesis
2017
Fragility fractures of the anterior pelvic ring are very often combined with fractures of the posterior pelvic ring. The large majority of the posterior fractures is situated in the sacral ala. Non-operative therapy may be cumbersome in patients with a combination of an anterior with a posterior pelvic ring fracture. Any surgical therapy should be as less invasive as possible. Iliosacral screw fixation is a minimal invasive technique. Variations of the upper sacral anatomy make optimal iliosacral screw placement challenging. The vestibule or isthmus is the narrowest part of the bony corridor from the lateral ilium to the S1 sacral body. It always points towards anterior and superior. The wh…