Augmented ilio-sacral screws for the treatment of fragility pelvic fractures: review of literature, presentation of a novel low-cost technique, and clinical results of a case series.

Abstract

Fragility pelvic fractures are an increasingly entity due to increase in life expectancy. A large proportion of these fractures require surgical treatment with stabilization of the posterior ring with ilio-sacral screws. Due to the poor bone quality of these patients, cement augmentation of the ilio-sacral screws can be performed and thus avoid treatment failures. The purpose of this review is to make a revision of the literature and present a novel cementation technique with clinical examples of patients treated with this surgical technique. Review of current literature on fragility pelvic fractures and modern treatment alternatives. We also describe a novel, easy to perform and low-cost technique for cement augmentation of ilio-sacral screws that we find useful when not having specific commercial instruments for this purpose. Additionally, we present a case series of five patients operated between 2017 and 2024 with augmented ilio-sacral screws due to fragility pelvic fracture. The surgical technique presented is easy to perform, has a low training curve and requires standard instruments easy to find in a trauma center. Further clinical studies are required to demonstrate superiority of cement augmentation over the standard technique without augmentation.