Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment

Background: Unstable posterior ring injuries of the pelvis are a challenge to pelvic surgeons, and their treatment has been controversial. The functional outcomes of such injuries following either percutaneous iliosacral screw fixation or conservative treatment remain to be elucidated. Methods: We...

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Main Authors: Po-Han Chen, Wei-Hsiu Hsu, Yen-Yao Li, Tsan-Wen Huang, Tsung-Jen Huang, Kuo-Ti Peng
Format: Article
Language:English
Published: Elsevier 2013-12-01
Series:Biomedical Journal
Subjects:
Online Access:http://www.biomedj.org/article.asp?issn=2319-4170;year=2013;volume=36;issue=6;spage=289;epage=294;aulast=Chen
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author Po-Han Chen
Wei-Hsiu Hsu
Yen-Yao Li
Tsan-Wen Huang
Tsung-Jen Huang
Kuo-Ti Peng
author_facet Po-Han Chen
Wei-Hsiu Hsu
Yen-Yao Li
Tsan-Wen Huang
Tsung-Jen Huang
Kuo-Ti Peng
author_sort Po-Han Chen
collection DOAJ
description Background: Unstable posterior ring injuries of the pelvis are a challenge to pelvic surgeons, and their treatment has been controversial. The functional outcomes of such injuries following either percutaneous iliosacral screw fixation or conservative treatment remain to be elucidated. Methods: We conducted a retrospective analysis of 32 consecutive patients with unstable pelvic ring injuries who were treated with percutaneous placement of iliosacral screws (group 1) or conservative means (group 2) from January 2002 to September 2009. Radiographic, clinical, and functional outcomes were compared between the two treatment groups. Results: Patients who underwent percutaneous iliosacral screw fixation after pelvic trauma had better functional results than those treated conservatively, as per the Majeed grading system. In addition, patients in group 1 demonstrated better results for general health and mental health on the 36 item Short Form Health Status Survey. Patients in group 1 also demonstrated less residual displacement on radiography at 1 year follow up than those in group 2. Finally, patients in group 1 had better pain relief at 1 month and 1 year follow ups than those in group 2. Conclusions: Percutaneous iliosacral screw fixation for unstable posterior pelvic ring injuries results in less residual displacement at medium term follow up, and better pain relief at short and medium term follow up, than does conservative treatment. Better functional outcomes were observed at 1 year follow up as compared with conservative treatment.
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spelling doaj.art-e04f98e0507e478a98957adfcaa805802022-12-22T02:19:43ZengElsevierBiomedical Journal2319-41702320-28902013-12-0136628929410.4103/2319-4170.112757Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatmentPo-Han Chen0Wei-Hsiu Hsu1Yen-Yao Li2Tsan-Wen Huang3Tsung-Jen Huang4Kuo-Ti Peng5Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, TaiwanBackground: Unstable posterior ring injuries of the pelvis are a challenge to pelvic surgeons, and their treatment has been controversial. The functional outcomes of such injuries following either percutaneous iliosacral screw fixation or conservative treatment remain to be elucidated. Methods: We conducted a retrospective analysis of 32 consecutive patients with unstable pelvic ring injuries who were treated with percutaneous placement of iliosacral screws (group 1) or conservative means (group 2) from January 2002 to September 2009. Radiographic, clinical, and functional outcomes were compared between the two treatment groups. Results: Patients who underwent percutaneous iliosacral screw fixation after pelvic trauma had better functional results than those treated conservatively, as per the Majeed grading system. In addition, patients in group 1 demonstrated better results for general health and mental health on the 36 item Short Form Health Status Survey. Patients in group 1 also demonstrated less residual displacement on radiography at 1 year follow up than those in group 2. Finally, patients in group 1 had better pain relief at 1 month and 1 year follow ups than those in group 2. Conclusions: Percutaneous iliosacral screw fixation for unstable posterior pelvic ring injuries results in less residual displacement at medium term follow up, and better pain relief at short and medium term follow up, than does conservative treatment. Better functional outcomes were observed at 1 year follow up as compared with conservative treatment.http://www.biomedj.org/article.asp?issn=2319-4170;year=2013;volume=36;issue=6;spage=289;epage=294;aulast=ChenPercutaneous iliosacral screwspelvic ring injurypelvis fracturesacrum fracture sacroiliac joint disruption
spellingShingle Po-Han Chen
Wei-Hsiu Hsu
Yen-Yao Li
Tsan-Wen Huang
Tsung-Jen Huang
Kuo-Ti Peng
Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment
Biomedical Journal
Percutaneous iliosacral screws
pelvic ring injury
pelvis fracture
sacrum fracture sacroiliac joint disruption
title Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment
title_full Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment
title_fullStr Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment
title_full_unstemmed Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment
title_short Outcome analysis of unstable posterior ring injury of the pelvis: Comparison between percutaneous iliosacral screw fixation and conservative treatment
title_sort outcome analysis of unstable posterior ring injury of the pelvis comparison between percutaneous iliosacral screw fixation and conservative treatment
topic Percutaneous iliosacral screws
pelvic ring injury
pelvis fracture
sacrum fracture sacroiliac joint disruption
url http://www.biomedj.org/article.asp?issn=2319-4170;year=2013;volume=36;issue=6;spage=289;epage=294;aulast=Chen
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