Your contact partners
in this area:
Prof. <br /> Dr. med. habil.<br /> Georg Matziolis
Dr. med. habil.
Georg Matziolis

Senior Consultant of the Clinic for Orthopaedics and Accident Surgery

Acting holder of the Chair for Orthopaedics of the FSU Jena at the Waldkrankenhaus Eisenberg

036691 8-1002

Oberarzt Dr. med. Alexander Hölzl
Oberarzt Dr. med. Alexander Hölzl

Facharzt für Orthopädie und Unfallchirurgie
Zusatzbezeichnungen: Spezielle Unfallchirurgie und Notfallmedizin

Specialist Registrar's Office
Gabi Geier

036691 8-1439

Fatigue fracture of the sacrum

Sacral insufficiency fracture


Minimally invasive stabilisation of the sacrum

Percutaneous dorsal internal fixator from hip bone to hip bone with trans-iliosacral screw

If a fatigue fracture of the sacrum is diagnosed on CT and MRI scan, and if the patient cannot mobilise with adequate pain therapy, surgical stabilisation is indicated. The surgery is carried out under general anaesthetic. The method we use involves making 1 cm long skin incisions and inserting screws under X-ray guidance through the sacroiliac joints into the sacrum. Specially manufactured screws are also positioned in the iliac wings, again under X-ray guidance. These are linked to a titanium rod that is tunnelled under the skin and bent to fit. This frame construction stabilises and compresses the fracture. Only the tiniest skin incisions are needed, keeping blood loss to a minimum. The operation takes around 90 minutes. The patient is able to mobilise immediately after the operation and the metalwork does not necessarily have to be removed.

Figure 1 

Bilateral fatigue fracture of the sacrum on CT (a) and MRI (b). The white areas on the MRI indicate the fractures

Figure 2 a und b:

The screws are inserted through the sacroiliac joint into the sacrum using a guide wire viewing the pelvis from the front. An old kyphoplasty in the 5th lumbar vertebra can also be seen.

Figure 2 c und d:

The screws are inserted into the iliac wings. Before the screws are inserted, the screw channels are probed to safeguard the correct position in the bone. View from the side. A total hip replacement can be seen at the edge of the image

Figure 3 a und b: 

Post-operative images with the screws in the correct position in the sacrum and iliac wings with the connecting titanium rod. Image b is slightly tilted in order to see the custom-curved titanium rod better.


Deutsches Zentrum für Orthopädie: Wirbelsäulenerkrankungen

In unserer Wirbelsäulensprechstunde beraten und betreuen wir Menschen mit Muskelverspannungen durch Fehlbelastung, Skeletterkrankungen (z.B. Osteoporose) und Abnutzungserscheinungen der Wirbelsäule oder Bandscheiben.
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