[Implant Augmentation in Pelvic Surgery. Options and Technique]

Overview

Journal Unfallchirurg

Date 2015 Sep 6

PMID 26341619

Citations 3

Authors

N Gruneweller

D Wahnert

M J Raschke

T Fuchs

Affiliations

Soon will be listed here.

Abstract

Background: Osteoporotic fractures of the pelvis are an increasing problem in trauma surgery. Sufficient implant anchorage is reduced due to the poor bone stock; however, early mobilization is especially necessary for geriatric patients in order to prevent additional complications.

Material And Methods: Implant augmentation may be one technique to increase implant anchorage and stability in osteoporotic bone. This procedure is currently used in the treatment of osteoporotic fractures of the dorsal pelvic ring. Beside the augmentation of iliosacral screws in the treatment of sacral insufficiency fractures, cement augmentation with lumbar or sacral pedicle screws is used for increased stability.

Indications And Risks: Implant augmentation in pelvic surgery should be indicated crucially due to the specific risks of the procedure. Cement leakage and heat generation during cement curing (when PMMA--polymethylmetacrylate--cement is used) can compromise neurovascular structures. Potential complications like cement embolism are possible.

Conclusion: The use of special implants (cannulated and perforated screws) as well as intraoperative navigation and 3D imaging increase patient safety and help to make implant augmentation a low risk procedure.

Citing Articles

Treatment of Type IV Fragility Fractures of Pelvis With Robotic-Assisted Minimally Invasive Triangular Fixation.

Tian W, Jia F, Zheng J, Liu Z, Jia J Orthop Surg. 2024; 17(3):848-857.

PMID: 39726284 PMC: 11872377. DOI: 10.1111/os.14338.

Instability of the posterior pelvic ring: introduction of innovative implants.

Gruneweller N, Wahnert D, Vordemvenne T J Orthop Surg Res. 2021; 16(1):625.

PMID: 34663398 PMC: 8525032. DOI: 10.1186/s13018-021-02770-2.

Comparison of Outcomes Following TiRobot-Assisted Sacroiliac Screw Fixation with Bone Grafting and Traditional Screw Fixation without Bone Grafting for Unstable Osteoporotic Sacral Fracture: A Single-Center Retrospective Study of 33 Patients.

Liu Z, Gu Y, Jin X, Tian W, Qi H, Sun Y Med Sci Monit. 2021; 27:e932724.

PMID: 34556623 PMC: 8480221. DOI: 10.12659/MSM.932724.

[Traumatology in the elderly : Multimodal prevention of delirium and use of augmentation techniques].

Wahnert D, Roos A, Glasbrenner J, Ilting-Reuke K, Ohrmann P, Hempel G Chirurg. 2017; 88(2):95-104.

PMID: 28058496 DOI: 10.1007/s00104-016-0339-2.

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