ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Unilateral sacral fragility fractures: a comparative study of unilateral vs. bilateral minimally invasive osteosynthesis.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Percutaneous fixation of posterior pelvic ring lesions in the elderly: current evidence and recent advances.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Review
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6 authors.
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Abstract
purposeUnilateral sacral fragility fractures are frequently managed with unilateral percutaneous iliosacral screw fixation, which may increase stress on the contralateral sacrum and lead to secondary fractures. This study compared complication rates between unilateral and bilateral screw osteosynthesis and evaluated risk factors for contralateral fracture following unilateral treatment.
methodsThis retrospective study included patients with unilateral sacral fragility fractures treated between 2018 and 2024. Patients were categorized into two groups: Group 1 (unilateral fixation) and Group 2 (bilateral fixation). Demographics, fracture morphology, and outcomes at 3 and 12 months postoperatively were assessed. Potential risk factors included comminution, sacral zone involvement, and concomitant anterior pelvic ring fractures.
resultsA total of 119 patients were analyzed (44 unilateral, 75 bilateral). The complication rate was significantly higher in the unilateral group (26% vs. 7.1%; p = 0.03). Contralateral fractures occurred more frequently in the unilateral group, particularly in the presence of anterior pelvic ring fractures, although this association was not statistically significant (p = 0.2).
conclusionsBilateral screw osteosynthesis significantly reduces complication rates compared to unilateral fixation in the treatment of unilateral sacral fragility fractures. These findings support the routine consideration of bilateral fixation, particularly in patients with concomitant anterior pelvic ring injuries, to minimize the risk of contralateral sacral failure.
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