Die S2-Ala-Ilium-Schraube in der Beckentraumatologie

Zusammenfassung

Perkutane Schraubenosteosynthesen gehören zum Versorgungsstandard von Frakturen des hinteren Beckenringes. Hin und wieder erfordern jedoch spezielle Situationen alternative Strategien zur suffizienten Stabilisierung. In den meisten Fällen kann die Stabilisierung mittels Spina-iliaca-posterior-superior-Schrauben (SIPS-Schrauben) erfolgen. Hierbei kann es allerdings zur implantatbedingten Aggravation der teils bereits kritischen dorsalen Weichteilsituationen nach Trauma kommen. Alternativ können S2-Ala-Ilium-Schrauben (S2AI-Schrauben) eingesetzt werden, deren Startpunkt sich über dem Sakrum medial der Spina iliaca posterior superior und unterhalb des Iliumniveaus liegt, mit einer potenziellen spinalen Instrumentierung nahezu in einer Flucht befindet und daher i. d. R. weniger Weichteilprobleme verursacht. Obwohl diese Technik in der Wirbelsäulenchirurgie in den letzten Jahren eine breite Anwendung gefunden hat, ist sie in der Traumatologie noch weitestgehend unbeschrieben. Die Möglichkeiten, aber auch die Limitationen dieser Technik für die Versorgung von Verletzungen des Beckens werden anhand einer retrospektiven Fallserie dargestellt.

Schlüsselwörter

Beckenfraktur - spinopelvin - S2-Ala-Ilium - hinterer Beckenring

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