Fragility fractures of the sacrum occur in elderly patients with severe loss of sacral bone mass.
Arch Orthop Trauma Surg
; 138(7): 971-977, 2018 Jul.
Article
en En
| MEDLINE
| ID: mdl-29700604
ABSTRACT
INTRODUCTION:
Patients suffering from osteoporosis-associated fragility fractures of the sacrum (FFS; also termed sacral insufficiency fractures) are increasingly observed. They have typical fracture patterns with fracture lines located in the sacral ala. When treating these patients operatively, iliosacral screw loosening is not uncommon. We aimed to study the sacral bone mass in patients presenting with a FFS using 3D statistical models. MATERIALS ANDMETHODS:
3D models of averaged Hounsfield units (HU) were generated based on CT scans from 13 patients with a unilateral FFS (mean age 79.6 years; 11 females, 2 males). The control group without fractures consisted of 28 males and 32 females (mean age of 68.3 years). A virtual bone probe along the trans-sacral corridors S1 and S2 was taken.RESULTS:
The bone mass distribution in the fractured sacra was similar to the control group, however, with overall lower HU. Large zones of negative HU were located in the sacral ala. In the fractured sacra, the HU in the sacral ala was significantly lower on the non-injured side when comparing to the fractured side (p < 0.001) as well as compared to the non-fractured group (p < 0.001). Low bone mass was observed in sacral body S1 (40 HU) and S2 (20 HU).CONCLUSIONS:
The extensive area of negative HU may explain the fracture location in the sacral ala. The low HU in the sacral bodies advocates the use of trans-sacral implants or augmented iliosacral screws to enhance the strength of fracture fixation. The increased HU in the fractured ala could be explained by fracture-asssociated hemorrhage and can be used as a diagnostic tool.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Sacro
/
Fracturas de la Columna Vertebral
/
Fracturas Osteoporóticas
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Aged
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Aged80
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Arch Orthop Trauma Surg
Año:
2018
Tipo del documento:
Article
País de afiliación:
Alemania