Innovative Crab-Shaped Spinopelvic Fixation with Offset Connectors for Managing an H-Shaped Sacral Fracture Featuring a Floating Roy-Camille Type 3 Transverse Component: A Case Study - Report - MDSpire

Innovative Crab-Shaped Spinopelvic Fixation with Offset Connectors for Managing an H-Shaped Sacral Fracture Featuring a Floating Roy-Camille Type 3 Transverse Component: A Case Study

  • By

  • Akinori Okuda

  • Keisuke Masuda

  • Hironobu Konishi

  • Masaki Ikejiri

  • Kenichi Nakano

  • Naoki Maegawa

  • Hideki Shigematsu

  • Hidetada Fukushima

  • Kenji Kawamura

  • March 27, 2026

  • 0 min

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Clinical Report: Innovative Crab-Shaped Spinopelvic Fixation for H-Shaped Fracture

Overview

This report presents a case of an unstable H-shaped sacral fracture treated with innovative crab-shaped spinopelvic fixation. The surgical approach included decompression and the use of offset connectors, demonstrating a viable option for complex pelvic injuries.

Background

Incorporate Denis classification details and its implications for H-shaped fractures.

Data Highlights

No numerical data or trial data provided in the article.

Key Findings

  • The patient presented with an unstable AO/OTA 61-C3.2 pelvic ring fracture and an H-shaped sacral fracture.
  • Decompression and a Kapandji-like reduction maneuver were employed during surgery.
  • Modified crab-shaped fixation using offset connectors was utilized to stabilize the fracture.
  • Intraoperative ultrasound confirmed the presence of a large free fragment in the S1 spinal canal.
  • The surgical approach aimed to restore load transfer and facilitate early rehabilitation.

Clinical Implications

Discuss comparison with traditional methods regarding recovery and complications.

Conclusion

This case highlights the effectiveness of crab-shaped spinopelvic fixation in addressing challenging H-shaped sacral fractures, underscoring the need for tailored surgical strategies in complex pelvic injuries.

References

  1. Biomechanical Assessment of the U-shaped Lumbopelvic Stabilization Method for Managing Unstable Sacral Fractures, 2025 -- Springer
  2. Evaluation of Sacroiliac Screw Insertion Using 3D-Printed Templates Versus X-Ray Fluoroscopy Guidance, 2019 -- Springer
  3. Innovative Minimally Invasive Tape Suture Technique for Stabilizing Pubic Symphysis Instabilities: A Biomechanical Analysis, 2021 -- Springer
  4. PRACTICE MANAGEMENT GUIDELINES FOR Hemorrhage in Pelvic Fracture, 2026 -- EAST
  5. Spinopelvic fixation for C3 Displaced sacral U-type fracture, -- AO Surgery Reference
  6. Acta Neurochirurgica — Percutaneous modified iliac screw fixation: technique and clinical experience
  7. PRACTICE MANAGEMENT GUIDELINES FOR
  8. Spinopelvic fixation for C3 Displaced sacral U-type fracture
  9. Biomechanical comparison of triangular osteosynthesis and triangular minimally invasive spinopelvic stabilization technique for pelvic fragility fractures - ScienceDirect

Original Source(s)

Innovative Crab-Shaped Spinopelvic Fixation with Offset Connectors for Managing an H-Shaped Sacral Fracture Featuring a Floating Roy-Camille Type 3 Transverse Component: A Case Study

  • by Akinori Okuda, Keisuke Masuda, Hironobu Konishi, Masaki Ikejiri, Kenichi Nakano, Naoki Maegawa, Hideki Shigematsu, Hidetada Fukushima, Kenji Kawamura

  • March 27, 2026

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