ArticleActa neurochirurgica2026
Modified spinopelvic crab-shaped fixation using offset connectors for a H-shaped sacral fracture with a floating Roy-Camille type 3 transverse component: a case report.
Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransverse sacral fractures with spinopelvic dissociation are highly unstable and can cause severe neurological compromise. In cases combining an H-shaped sacral fracture, a floating Roy-Camille type 3 component, and a free canal fragment, posterior plating, standard spinopelvic fixation, or transiliac-transsacral screw fixation may be unsafe, particularly after decompression, due to a dorsal cortical defect.
methodA 49-year-old woman sustained polytrauma after a fall from the fifth floor, including an AO/OTA 61-C3.2 unstable pelvic ring injury. Computed tomography (CT) demonstrated an H-shaped sacral fracture with an S1-2 transverse Roy-Camille type 3 component and a large canal fragment with bilateral fractures and a floating distal sacral fragment. After angioembolization for active pelvic hemorrhage and damage control orthopedics, definitive posterior surgery was performed on post-injury day 5. Decompression was achieved via laminectomy (L5-S2) and removal of the canal fragment. The floating sacral fragment was reduced using a Kapandji-like maneuver with bilateral neurodissectors. Minimally invasive crab-shaped spinopelvic fixation was performed using bilateral iliac screws and percutaneous L5 pedicle screws connected using transverse rods and longitudinal offset connectors. Offset connectors were positioned along the dorsal sacral cortex as buttresses to prevent redisplacement of the distal fragment and secured around the S2 spinous process.
resultsThe operative time was 270 min, with 100 mL of blood loss. Postoperative imaging confirmed a satisfactory reduction. Mild anterior shortening occurred within three months without progression, union at six months, or complete union without implant failure at 1 year. The patient regained independent ambulation with mild residual sensory disturbances and urinary dysfunction.
conclusionModified crab-shaped fixation using offset connectors as dorsal buttresses can provide stable reduction and maintain alignment until union in complex spinopelvic dissociation patterns where standard constructs or transiliac transsacral screw (TITSS) are not feasible.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.