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Surgical technique of percutaneous iliosacral screw fixation in S3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: Two case reports

INTRODUCTION: Percutaneous screw fixation is considered the best option in unstable pelvic fracture with severe soft tissue injury. However, fixation technique at the level of S3 has not been well established. This paper showed the feasible surgical technique of S3 screw insertion in unstable pelvic...

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Autores principales: Dilogo, Ismail H., Fiolin, Jessica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522959/
https://www.ncbi.nlm.nih.gov/pubmed/28735116
http://dx.doi.org/10.1016/j.ijscr.2017.07.008
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author Dilogo, Ismail H.
Fiolin, Jessica
author_facet Dilogo, Ismail H.
Fiolin, Jessica
author_sort Dilogo, Ismail H.
collection PubMed
description INTRODUCTION: Percutaneous screw fixation is considered the best option in unstable pelvic fracture with severe soft tissue injury. However, fixation technique at the level of S3 has not been well established. This paper showed the feasible surgical technique of S3 screw insertion in unstable pelvic fracture with severe soft tissue injury. METHODS: We reported 2 cases of unstable pelvic injury of an 11 years old boy with Marvin-Tile (MT) C1 pelvic fracture with sacroiliac (SI) joint disruption, skin avulsion and Morel-Lavallée lesion. Second case was 30 years old male with open pelvic fracture MTB2 and vertical sacral fracture Denis zone I with Morel-Lavallée lesion, intraperitoneal bladder rupture, infected laparotomy wound dehiscence. We performed percutaneous screws insertion on both pubic rami and IS screw on S1 and S3 to both cases. Functional outcome was evaluated using Majeed and Hannover pelvic score. RESULTS: All patients survived and had good reduction with no residual displacement on SI joint. The former case at 21-month follow up presented with excellent outcome (100/100) by Majeed score and very good outcome (4/4) by Hannover score; while the latter case, at 18-month, present with good outcome (85/100) Majeed score and fair outcome (2/4) Hannover score. CONCLUSIONS: Percutaneous screw fixation at the level of S3 is feasible and can be inserted in S3 level by sacroiliac type and sacral type with minimal soft tissue intervention and good functional outcome.
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spelling pubmed-55229592017-07-31 Surgical technique of percutaneous iliosacral screw fixation in S3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: Two case reports Dilogo, Ismail H. Fiolin, Jessica Int J Surg Case Rep Case Report INTRODUCTION: Percutaneous screw fixation is considered the best option in unstable pelvic fracture with severe soft tissue injury. However, fixation technique at the level of S3 has not been well established. This paper showed the feasible surgical technique of S3 screw insertion in unstable pelvic fracture with severe soft tissue injury. METHODS: We reported 2 cases of unstable pelvic injury of an 11 years old boy with Marvin-Tile (MT) C1 pelvic fracture with sacroiliac (SI) joint disruption, skin avulsion and Morel-Lavallée lesion. Second case was 30 years old male with open pelvic fracture MTB2 and vertical sacral fracture Denis zone I with Morel-Lavallée lesion, intraperitoneal bladder rupture, infected laparotomy wound dehiscence. We performed percutaneous screws insertion on both pubic rami and IS screw on S1 and S3 to both cases. Functional outcome was evaluated using Majeed and Hannover pelvic score. RESULTS: All patients survived and had good reduction with no residual displacement on SI joint. The former case at 21-month follow up presented with excellent outcome (100/100) by Majeed score and very good outcome (4/4) by Hannover score; while the latter case, at 18-month, present with good outcome (85/100) Majeed score and fair outcome (2/4) Hannover score. CONCLUSIONS: Percutaneous screw fixation at the level of S3 is feasible and can be inserted in S3 level by sacroiliac type and sacral type with minimal soft tissue intervention and good functional outcome. Elsevier 2017-07-08 /pmc/articles/PMC5522959/ /pubmed/28735116 http://dx.doi.org/10.1016/j.ijscr.2017.07.008 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Dilogo, Ismail H.
Fiolin, Jessica
Surgical technique of percutaneous iliosacral screw fixation in S3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: Two case reports
title Surgical technique of percutaneous iliosacral screw fixation in S3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: Two case reports
title_full Surgical technique of percutaneous iliosacral screw fixation in S3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: Two case reports
title_fullStr Surgical technique of percutaneous iliosacral screw fixation in S3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: Two case reports
title_full_unstemmed Surgical technique of percutaneous iliosacral screw fixation in S3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: Two case reports
title_short Surgical technique of percutaneous iliosacral screw fixation in S3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: Two case reports
title_sort surgical technique of percutaneous iliosacral screw fixation in s3 level in unstable pelvic fracture with closed degloving injury and morrell lavallee lesion: two case reports
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522959/
https://www.ncbi.nlm.nih.gov/pubmed/28735116
http://dx.doi.org/10.1016/j.ijscr.2017.07.008
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