Our results of spinopelvic fixation in vertical unstable pelvic fractures and transverse sacrum fractures

Aim: In this study, the radiological and clinical results of our patients who underwent spinopelvic fixation in vertical unstable pelvic fractures and transverse sacrum fractures were evaluated and the functions affecting the results were evaluated. Material and Method: 11 patients who underwent spinopelvic fixation due to vertical instability and transverse sacrum fractures in Dicle University Faculty of Medicine, Department of Orthopedics and Traumatology between 2017-2020 were retrospectively analyzed. 11 patients who had clinical follow-ups and whose radiological data were appropriate were included in the study. Preoperative tomography was used in the radiological evaluation of the patients, outlet, inlet and lateral sacrum radiography in postoperative follow- up. Majeed Functional Scoring and Hannover Pelvis Scoring were used for functional results. Gibbon Neurological Grade was used for neurological follow-up of the patients. Results: Seven (63,6%) of the cases were male and 4 (36,4%) were female. The mean age was 24,6 (15–45) years, followed by 12,3 (4–29) months. 1 (9%) of the patients were Denis Zone I, 5 (45.4%) of patients were Denis Zone II and 5 (45.4) of patients were Zone III. The mean time for surgery was 5 (1–19) days. We applied unilateral spinopelvic fixation in five patients, bilateral spinopelvic fixation in 4 patients, and unilateral spinopelvic fixation in 2 patients and bilateral fixation to the lumbar vertebra. We used a single iliac screw for all patients. Our displacement mean before surgery was 14.27 ± 4.3 (6-20) mm, the mean postoperative displacement was 4.27 ± 2.24 (0-8) mm. In patients with preoperative transverse sacrum fractures, the mean angle of kyphosis is 66.4 ± 24 (45-95) mm postoperative kyphosis angle is 41 ± 17 (25-65) mm. The mean Gibbons grade before surgery was 2.9 ± 1.2 (1-4). The mean injury severity score(ISS) of the patients was 41.36 ± 12 (29-75). Mean Majed functional score was 75 ± 14 (50–96) at the last control of the patients. 4 (36.4%) of the patients were excellent, 4 (36.4%) were good and 2 (18.2%) were moderate and 1 (9%) was poor. At the last control, the mean Hannover pelvis outcome score of the patients was 5.36 ± 1.5 (3-7). At the last control, Gibbons grade mean was 2.18 ± 1.47 (1-4). Age, gender and type of trauma do not affect functional outcomes (p> 0.05). However, there is a correlation with functional results in terms of preoperative gibbons score, preoperative displacement amount, injury severity score and duration of preoperation (p <0.05). .Conclusion: Spinopelvic fixation in vertical unstable pelvic fractures and transfers sacrum fractures is a procedure that provides early mobilization and early neurological stabilization, has good neurological scores, functional scores, and radiological results, and is less complicated when performed by experienced surgeons.