Assessment of efficacy of conservative and surgical treatment methods in patients with unstable sacral fractures

Background. Treatment of patients with combined injury and unstable sacral fractures is a complex interdisciplinary problem due to high risks of mortality and neurological complications, and long rehabilitation. The study is important because of the absence of a consensus on the optimal time and technique of surgical stabilization, as well as on further treatment of patients with unstable sacral fractures. Aim. To analyze results of treatment of patients with unstable sacral fractures (type С per the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification). Materials and methods. The retrospective study included 67 patients aged 18 to 65 years with diagnosis of unstable sacral fracture (2014–2023). Depending on treatment tactics, 2 groups were identified: group 1 received surgical treatment ( n = 54) with subgroup 1А undergoing sacroiliac fixation ( n = 26), group 1B – triangular fixation ( n = 25), group 1В – sacral canal decompression ( n = 3); group 2 received conservative treatment ( n = 13). Assessment of treatment efficacy included analysis of the following parameters: time to mobilization, complications, functional outcomes (Majeed scale), neurological status (Gibbons scale). Results. Time to mobilization in the group 1 (surgical treatment) was 6.2 ± 3.8 days (subgroup 1А), in the group 2 (conservative treatment) – 31.4 ± 8.3 days ( p