Functional Outcome With Percutaneous Ilio-sacral Screw Fixation For Posterior Pelvic Ring Injuries In Patients Involved In Heavy Manual Laboring.

Abhishek Sm,Harshal K,Azhar Al,Prashanth ,Vijay Gb

doi:10.5704/moj.1511.003

Abstract

Introduction: Unstable posterior pelvic ring injuries are best treated with operative methods due to better post-op functional score. Our patient cohort was involved in heavy manual laboring frequently required ground level work in their activities of daily living. There are very few outcome studies dealing exclusively with such patients.Materials & Methods: Forty one patients who were treated with percutaneous sacroiliac screw fixation under fluoroscopic guidance and were followed-up for at least one year were analyzed retrospectively for functional outcome using the Majeed score.Results: Twenty one (51.22%) and thirteen (31.70%) patients were found to be in excellent and good categories respectively and majority of the patients (thirty/73.17%) were able to return to their original occupation with or without minor adjustments.Conclusion: Percutaneous ilio-sacral screw fixation for posterior pelvic unstable injuries is an acceptable mode of treatment in patients involved in heavy manual laboring.

Highlights

Unstable posterior pelvic ring injuries are best treated with operative methods due to better post-op functional score
Has been shown to provide good biomechanical stability & functional outcome and is a good compromise between nonoperative management having risk of residual disability in unstable injuries and open procedures having risk of infections due to excessive soft tissue stripping . 2,1,3 Though there are proponents of each of them, there have been very few studies focusing exclusively on the outcome of the percutaneous screw fixation in the rural populations of developing countries where unlike the Western countries, squatting, sitting cross-legged and frequent forward bending are an important component of activities of daily living and majority of the population is involved in some form of heavy manual laboring
Percutaneous ilio-sacral screw fixation for posterior pelvic unstable injuries is an acceptable mode of treatment in patients involved in heavy manual laboring

Summary

Introduction

Unstable posterior pelvic ring injuries are best treated with operative methods due to better post-op functional score. Our patient cohort was involved in heavy manual laboring frequently required ground level work in their activities of daily living. There are very few outcome studies dealing exclusively with such patients. Posterior pelvic ring (PPR) injuries are serious injuries with high rates of mortality and morbidity due to other associated injuries and due to the pelvic trauma itself. Three modes of treatment have been advocated for PPR disruptions; viz. Non-operative, open reduction & fixation and percutaneous screw fixation 1.

Methods

Results

Discussion

Conclusion