Abstract
PurposeReduction and percutaneous screw fixation of sacroiliac joint disruptions and sacral fractures are surgical procedures for stabilizing the posterior pelvic ring. It is unknown, however, whether smaller irregularities or the inability to achieve an anatomic reduction of the joint and the posterior pelvic ring affects the functional outcome. Here, the long-term well-being of patients with and without anatomic reduction of the posterior pelvis after sacroiliac joint disruptions is described.MethodsBetween 2011 and 2017, 155 patients with pelvic injuries underwent surgical treatment. Of these, 39 patients with sacroiliac joint disruption were examined by radiological images and computer tomography (CT) diagnostics and classified according to Tile. The functional outcome of the different surgical treatments was assessed using the short form health survey-36 (SF-36) and the Majeed pelvic score.ResultsComplete data sets were available for 31 patients, including 14 Tile type C and 17 type B injuries. Of those, 26 patients received an anatomic reduction, 5 patients obtained a shift up to 10 mm (range 5–10 mm). The SF-36 survey showed that the anatomic reduction was significantly better in restoring the patient’s well being (vitality, bodily pain, general mental health and emotional well-being). Patients without this treatment reported a decrease in their general health status.ConclusionsAnatomic reduction was achieved in over 80% of patients in this study. When comparing the long-term well-being of patients with and without anatomic reduction of the posterior pelvis after sacroiliac joint disruptions, the results suggest that anatomical restoration of the joint is beneficial for the patients.
Highlights
Pelvic ring injuries account for approximately 3% of all fractures, and are relatively rare injuries [1, 2]
Fundamental differences allow to distinguish between type B and C injuries [3, 4], differences concerning the outcome of their surgical treatment (p = 0.055) were not observed
Thirty-nine consecutive patients (mean age: 47.15 years; 14 females and 25 males) with sacroiliac joint disruptions were included in this retrospective observational study of prospectively collected data
Summary
Pelvic ring injuries account for approximately 3% of all fractures, and are relatively rare injuries [1, 2]. It was referred to a sacroiliac joint disruption if the sacroiliac joint width exceeds 4 mm and lacks its normal symmetrical appearance as determined by CT imaging According to these criteria pure sacroiliac disruptions are rare, but not yet described as such in the literature. Multiple studies have shown that reduction and stabilization of sacroiliac joint disruptions affect the outcome, in the majority of these studies it is concluded that reduction to within 5 mm of the opposite unaffected side or the upper end of the width of the native joint (4 mm) is not associated with an adverse outcome [5, 6] This suggests that residual malreduction, even a minimal one, is associated with an adverse clinical and functional outcome. The present study investigates the reduction of sacroiliac joint disruptions and correlates reduction with clinical and functional outcome
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