ArticleJournal of clinical orthopaedics and trauma2025
Clinical and radiological outcomes of lumbopelvic fixation in unstable Isler type II and III sacral fractures.
Article in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Abstract
Background: Sacral fractures constitute a significant portion of pelvic fractures, ranging from 10 % to 45 %. Among sacral fractures, 17 %-30 % are categorized as unstable. The objective of the study was to investigate the clinical and radiological outcomes associated with lumbopelvic fixation (LPF) in Isler II and Isler III unstable sacral fractures. Methods: A Prospective cohort study was conducted at tertiary care Hospital Lahore from January 2019 to December 2021. Patients were followed up till July 2023. Patients diagnosed with unstable Isler II and Isler III sacral fractures who underwent LPF utilizing a posterior triangular osteosynthesis (PTO) were analyzed. Comprehensive clinical and radiological assessments were conducted preoperatively and postoperatively (following a 2-year follow-up period). Evaluation of clinical and radiological outcomes was made. Results: In a total of 13 patients, the majority were male (8 patients, 61.5 %), with an average age of 27.46 ± 3.73 years at the time of surgery. Neurologic function was impaired in 9 patients (69.2 %). Seven patients (53.8 %) had Isler II fractures, while the remaining 6 patients (46.2 %) had Isler III fractures. The mean preoperative Visual Analog Scale (VAS) score improved significantly from 6.62 ± 1.12 to 1.85 ± 0.80 postoperatively (p < 0.0001). The mean postoperative Oswestry Disability Index (ODI) score improved from 82.15 ± 6.61 to 17.61 ± 1.45 (p < 0.0001). Radiologically, complete fracture healing was observed in all patients, with none requiring revision surgery. Residual deformity was present in 4 patients (30.8 %), but it was deemed clinically insignificant. Two patients (15.4 %) experienced superficial surgical site infections (SSI), which were effectively treated with antibiotics. Conclusion: Lumbopelvic fixation for Isler II and III unstable sacral fractures significantly improved pain and disability scores, with complete fracture healing observed in all patients. Residual deformities were clinically insignificant, and the procedure demonstrated a favorable safety profile.
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