Efficacy of homeopathic reduction with minimally invasive adjustable plate for treatment of sacral fractures

Abstract

Objective To investigate the clinical effect of homeopathic reduction with minimally invasive adjustable plate in treatment of sacral fractures. Methods A retrospective case-control study was conducted to assess the data of 89 patients with sacral fractures treated from January 2013 to January 2015. There were 49 males and 40 females, with a mean age of 37.8 years (range, 18-70 years). Denis classification was type Ⅰ in 24 patients, type Ⅱ in 48, and type Ⅲ in 17. Patients were divided into three groups according to fixation methods: homeopathic reduction with minimally invasive adjustable plate group (Group A, n=30), sacroiliac screw group (Group B, n=31) and iliolumbar rod group (Group C, n=28). Operation time, blood loss, intraoperative radiographic time, and complications were recorded. Reduction quality was assessed using the Matta criteria. Bone healing was evaluated based on X-ray appearance. Functional outcome was evaluated using the Majeed score at last follow-up. Results Operation time was significantly lower in Group A [(109.3±14.4)min] and Group B [(114.2±17.7)min] than Group C [(126.8±15.7)min](P 0.05). Blood loss was significantly lower in Group A [(433.3±121.3)ml] and Group B [(461.3±130.8)ml] than Group C [(785.7±205.0)ml](P 0.05). Radiographic time was (5.6±1.9)s in Group A, (13.4±3.1)s in Group B, and (8.4±2.5)s in Group C, showing significant difference among the three groups (P 0.05). Fracture healing was found in all patients and no nonunion was observed. Excellent rate of Majeed score in Group A [80%(24/30)] and Group C [82%(23/28)] was higher than that in Group B [54%(17/31)], but the there was no significant difference between Groups A and C (P>0.05). Complication rate in Group B [29%(9/31)] and Group C [29%(8/28)] were higher than that in Group C [3%(1/30)], but the there was no significant difference between Groups B and C (P>0.05). Conclusion For sacral fractures, homeopathic reduction with minimally invasive adjustable plate can reduce operation time and intraoperative radiographic time, improve reduction rate and lower incidence of complications. Key words: Sacrum; Fracture fixation, internal; Traction