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European Journal of Trauma and Emergency Surgery

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01-08-2015 | Original Article

Functional outcome of unstable pelvic ring injuries after iliosacral screw fixation: single versus two screw fixation

Authors: S. A. Khaled, O. Soliman, M. A. Wahed

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2015

Abstract

Introduction

A clinical series of patients was studied to compare the functional score after the use of a single versus two percutaneous iliosacral screws for unstable posterior pelvic ring fractures with or without anterior fixation with the aim to explore if the addition of a second screw would provide better results regarding the functional outcome score.

Materials and methods

This case series includes 77 patients with an average of 32.6 years who suffered unstable posterior pelvic ring fractures. Forty-six were Tile type C and 31 were Tile type B. Patients underwent closed reduction and were fixed using percutaneous fluoroscopic-guided iliosacral screws in the supine position with 1 screw in 50 fractures, 2 screws in 37 fractures, 2 fractures were fixed with plates after ORIF, and in 6 cases (out of the bilateral cases) the undisplaced side was unfixed. Postoperatively three patients were lost to follow up and 74 patients (84 posterior fractures fixed with screws) were followed up for a mean of 37.4 months (range 6–151 months) and were evaluated using the Majeed score (1989).

Results

Clinical union occurred in all the patients, although in two cases posterior fixation failed and was revised. Radiologically excellent reduction was achieved in 55 patients (71.4 %), good in 16 (20.8 %), fair in 6 (7.8 %) and none had poor reduction. Statistically; among 62 cases that completed the Majeed score evaluation at the last follow-up session, there was no significant difference p value 0.051 between two groups. We also compared Majeed score in Tile B and C fractures fixed with one versus two screws.

Conclusion

The addition of a second screw for posterior fixation did not show any statistically significant difference regarding functional outcome.

Level of evidence

Level IV clinical trial.

Available only for authorised users

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Title: Functional outcome of unstable pelvic ring injuries after iliosacral screw fixation: single versus two screw fixation
Authors: S. A. Khaled
O. Soliman
M. A. Wahed
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 4/2015
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-014-0456-x

At a glance: The STEP trials

Springer Medicine

Functional outcome of unstable pelvic ring injuries after iliosacral screw fixation: single versus two screw fixation

Abstract

Introduction

Materials and methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Level of evidence

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