Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping review
Purpose In the setting of sacral fractures, percutaneous screw fixation is a reliable, safe, and minimally invasive method for managing most stable and unstable fractures. However, significant variations in sacral anatomy due to sacral dysmorphism (SDM) could prevent safe implementation. This scopin...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2025-06-01
|
| Series: | Journal of Orthopaedics, Trauma and Rehabilitation |
| Online Access: | https://doi.org/10.1177/22104917241256657 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849328252031598592 |
|---|---|
| author | Fawaz N Alshaalan Omar A Al-Mohrej Naif N Hakeem Jamal Al-Asiri Herman Johal |
| author_facet | Fawaz N Alshaalan Omar A Al-Mohrej Naif N Hakeem Jamal Al-Asiri Herman Johal |
| author_sort | Fawaz N Alshaalan |
| collection | DOAJ |
| description | Purpose In the setting of sacral fractures, percutaneous screw fixation is a reliable, safe, and minimally invasive method for managing most stable and unstable fractures. However, significant variations in sacral anatomy due to sacral dysmorphism (SDM) could prevent safe implementation. This scoping review aimed to highlight such a detrimental yet under-reported variable in managing sacral fractures. Methods A scoping review was conducted following the Arksey and O’Malley framework for scoping studies. A comprehensive literature search of four electronic databases was conducted to identify relevant peer-reviewed studies. Data were extracted from eligible articles to summarize, collate, and create a narrative account of the findings. Results Twenty-one articles were included in our review (18 level III, two level II, and one level I). Studies were categorized into three main groups based on the investigated outcomes: prevalence and determinants of SDM, effect of SDM on the surgical corridor, and efficacy of different intra-operative imaging modalities. The prevalence of SDM ranged from 10 to 85%. The presence of SDM decreased the available surgical corridor at S1, with a compensated increase at S2 and S3. Mixed results regarding accuracy and revision rate were identified between different intra-operative imaging techniques. Conclusion SDM represents consistent yet atypical “safe zone,” sizes, and angles that require careful analysis and technique alterations when placing upper and second sacral segment screws. Considering their limited availability, high cost, and mixed results, navigated imaging systems represent a promising technique that requires more rigorous examination of its efficacy before widespread adoption. |
| format | Article |
| id | doaj-art-2172bbdd6db4473e96a684939b74a347 |
| institution | Kabale University |
| issn | 2210-4925 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedics, Trauma and Rehabilitation |
| spelling | doaj-art-2172bbdd6db4473e96a684939b74a3472025-08-20T03:47:38ZengSAGE PublishingJournal of Orthopaedics, Trauma and Rehabilitation2210-49252025-06-013210.1177/22104917241256657Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping reviewFawaz N Alshaalan0Omar A Al-Mohrej1Naif N Hakeem2Jamal Al-Asiri3Herman Johal4 Department of Orthopedic Surgery, , Riyadh, Saudi Arabia Section of Orthopedic Surgery, Department of Surgery, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdul Rahman University, Riyadh, Saudi Arabia Division of Orthopaedic Surgery, Department of Surgery, , Hamilton, Canada Division of Orthopaedic Surgery, Department of Surgery, , Hamilton, Canada Division of Orthopaedic Surgery, Department of Surgery, , Hamilton, CanadaPurpose In the setting of sacral fractures, percutaneous screw fixation is a reliable, safe, and minimally invasive method for managing most stable and unstable fractures. However, significant variations in sacral anatomy due to sacral dysmorphism (SDM) could prevent safe implementation. This scoping review aimed to highlight such a detrimental yet under-reported variable in managing sacral fractures. Methods A scoping review was conducted following the Arksey and O’Malley framework for scoping studies. A comprehensive literature search of four electronic databases was conducted to identify relevant peer-reviewed studies. Data were extracted from eligible articles to summarize, collate, and create a narrative account of the findings. Results Twenty-one articles were included in our review (18 level III, two level II, and one level I). Studies were categorized into three main groups based on the investigated outcomes: prevalence and determinants of SDM, effect of SDM on the surgical corridor, and efficacy of different intra-operative imaging modalities. The prevalence of SDM ranged from 10 to 85%. The presence of SDM decreased the available surgical corridor at S1, with a compensated increase at S2 and S3. Mixed results regarding accuracy and revision rate were identified between different intra-operative imaging techniques. Conclusion SDM represents consistent yet atypical “safe zone,” sizes, and angles that require careful analysis and technique alterations when placing upper and second sacral segment screws. Considering their limited availability, high cost, and mixed results, navigated imaging systems represent a promising technique that requires more rigorous examination of its efficacy before widespread adoption.https://doi.org/10.1177/22104917241256657 |
| spellingShingle | Fawaz N Alshaalan Omar A Al-Mohrej Naif N Hakeem Jamal Al-Asiri Herman Johal Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping review Journal of Orthopaedics, Trauma and Rehabilitation |
| title | Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping review |
| title_full | Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping review |
| title_fullStr | Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping review |
| title_full_unstemmed | Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping review |
| title_short | Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping review |
| title_sort | sacral dysmorphism and its influence on hardware choice in sacral fractures a scoping review |
| url | https://doi.org/10.1177/22104917241256657 |
| work_keys_str_mv | AT fawaznalshaalan sacraldysmorphismanditsinfluenceonhardwarechoiceinsacralfracturesascopingreview AT omaraalmohrej sacraldysmorphismanditsinfluenceonhardwarechoiceinsacralfracturesascopingreview AT naifnhakeem sacraldysmorphismanditsinfluenceonhardwarechoiceinsacralfracturesascopingreview AT jamalalasiri sacraldysmorphismanditsinfluenceonhardwarechoiceinsacralfracturesascopingreview AT hermanjohal sacraldysmorphismanditsinfluenceonhardwarechoiceinsacralfracturesascopingreview |