Background. The suicidal jumper's fracture of the pelvis is a special form of sacrum fractures associated with high energy trauma. The typical H-type fracture pattern runs transforaminal on both sides with a connecting transverse component between S1 and S3. Due to the high-grade instability operative treatment is imperative. Aim of this study was to compare iliosacral double screwing (2×7,3mm canulated screw with 16mm thread) with spinopelvic internal fixation. Methods. Both methods were tested on 6 synthetic and 6 anatomical pelvises. After osteotomy and alternating osteosynthesis stability was tested with a universal testing machine (Zwick) in a simulated two-leg stand. Data were generated by a 3-dimensional computer-assisted ultrasoundsystem (Zebris©) (3 translational datasets x,y,z and 3 ankles). Testing was performed after preload of 50N and two setting cycles of 100N followed by a full load cycle of 150N. ASCII-data were then transferred to SPSS for statistical analysis. Results. Both experimental series showed similar results. There was a tendancy of less displacement when iliosacral screwing was performed. However, no statistical significance could be observed between both techniques. Discussion. Although the spinopelvic internal fixation is a more rigid system, the double screwing may compensate this as it interacts in the center of the fracture. We therefore think that iliosacral double screwing is an appropriate technique for stabilisation of this special fracture type. The possibility of percutaneous osteosynthesis and of its performance in a supine position, this procedure provides essential advantages for the operative treatment of
The impact of concomitant injuries in patients with proximal femoral fractures has rarely been studied. To date, the few studies published have been mostly single-centre research focusing on the influence of upper limb fractures. A retrospective cohort analysis was, therefore, conducted to identify the impact and distribution of concomitant injuries in patients with proximal femoral fractures. A retrospective, multicentre registry-based study was undertaken. Between 1 January 2016 and 31 December 2019, data for 24,919 patients from 100 hospitals were collected in the Registry for Geriatric Trauma. This information was queried and patient groups with and without concomitant injury were compared using linear and logistic regression models. In addition, we analyzed the influence of the different types of additional injuries.Aims
Methods
Displaced, comminuted acetabular fractures in the elderly are increasingly common, but there is no consensus on whether they should be treated non-surgically, surgically with open reduction and internal fixation (ORIF), or with acute total hip arthroplasty (THA). A combination of ORIF and acute THA, an approach called ’combined hip procedure’ (CHP), has been advocated and our aim was to compare the outcome after CHP or ORIF alone. A total of 27 patients with similar acetabular fractures (severe acetabular impaction with or without concomitant femoral head injury) with a mean age of 72.2 years (50 to 89) were prospectively followed for a minimum of two years. In all, 14 were treated with ORIF alone and 13 were treated with a CHP. Hip joint and patient survival were estimated. Operating times, blood loss, radiological outcomes, and patient-reported outcomes were assessed.Aims
Patients and Methods
