One-Year Functional Outcomes in Posterior Pelvic Ring Injuries Treated with Percutaneous Iliosacral Screws: a Cohort Study from a Tertiary Care Hospital

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作者
Bharathkumar Balasubramanian
Pratyush Kumar
Vishnu B. Unnithan
Shyam Pandari MVG
Kumar Abhishek
机构
[1] University Hospitals Birmingham NHS Foundation Trust,Department of Nuclear Medicine
[2] Dr. Baba Saheb Ambedkar Medical College and Hospital,undefined
[3] Seth GS Medical College and KEM Hospital,undefined
[4] TSRTC Hospital,undefined
关键词
Posterior pelvic ring injury; Tile fractures; Iliosacral screws; Percutaneous fixation; Majeed scoring system; Injury severity score;
D O I
10.1007/s42399-023-01596-9
中图分类号
学科分类号
摘要
Posterior pelvic ring injuries occur as part of polytrauma. These are associated with long-term complications including urogenital dysfunction, pain, and limb abnormalities requiring prolonged rehabilitation. The study aimed to evaluate functional outcomes and look for clinically significant differences among 42 unstable Tile B and Tile C fractures in patients having posterior pelvic ring injuries treated with percutaneous sacroiliac screw fixation. After ethics approval, informed consent was taken from the patients. Their sociodemographic data were recorded, and injury severity scores were calculated prior to percutaneous fixation with iliosacral screws. Intraoperative parameters and postoperative recovery were noted. They were scored using the Majeed scoring system at 1 year of follow-up. Descriptive analysis was done along with the Mann–Whitney test, and Spearman’s correlation was calculated. The mean age of the patients was 40 years. The mean injury severity score was 30.88 with most patients suffering polytrauma. The mean operating time was 26.43 min, and the mean postoperative reduction in hemoglobin was 1.50 mg/dl. The average period to full weight–bearing mobilization was 3.19 months after surgery. No association was noted between the type of fracture and operative parameters. At 1 year of follow-up, the mean Majeed score was 88.31. Injury severity score had a negative correlation with the Majeed score (p-value = 0.006) and a positive correlation with time to full weight–bearing mobilization (p-value = 0.02). There are currently no clinical guidelines governing the management of posterior pelvic ring fractures. Percutaneous fixation of iliosacral screws is an effective management technique for these cases, offering a good prognosis.
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