Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study

Background and Aims: Posterior pelvic ring disruption has been associated with high-energy trauma, and significant morbidity and mortality. We aimed to determine functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries at a major trauma centre. Metho...

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Main Authors: Grace EM Kennedy, Ramy Rashed, Joshua Lau, Maham Khan, Mohammad Abdelmonem, Sathya Lakpriya, Bryony Ford, Ahmed El-Bakoury
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Surgery in Practice and Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666262025000221
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author Grace EM Kennedy
Ramy Rashed
Joshua Lau
Maham Khan
Mohammad Abdelmonem
Sathya Lakpriya
Bryony Ford
Ahmed El-Bakoury
author_facet Grace EM Kennedy
Ramy Rashed
Joshua Lau
Maham Khan
Mohammad Abdelmonem
Sathya Lakpriya
Bryony Ford
Ahmed El-Bakoury
author_sort Grace EM Kennedy
collection DOAJ
description Background and Aims: Posterior pelvic ring disruption has been associated with high-energy trauma, and significant morbidity and mortality. We aimed to determine functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries at a major trauma centre. Methods: Patients who underwent sacroiliac screw fixation at our institution, between 1st January 2013 – 1st April 2020 were identified from a database. Electronic systems were accessed to obtain information regarding patient demographics, injuries sustained, and interventions performed. Patients were contacted via telephone regarding clinical outcomes (EQ5D3L, EQVAS and Majeed scores). Radiographical outcomes were assessed using the Keshishyan cross-measure method. Results: 115 patients were identified. The mean age at injury was 51.6 years (17–84 years). Most injuries resulted from falls and road traffic collisions (83.5 %). Eighty patients (69.6 %) sustained additional non-pelvic injuries and twenty-nine (25.2 %) underwent a non-pelvic procedure, most commonly limb or clavicle fracture fixation (N = 19). Thirty-day and 12-month all-cause mortality rates were 0.9 % and 1.7 %, respectively. Clinical outcomes were obtained for 82/105 possible patients (78.1 %). Regarding EQ5D3L, 36/82 patients (43.9 %) reported a full health status; only six patients reported severe problems. The mean Majeed score was 70.3. 49/59 patients (86.0 %) returned to their pre-injury employment. A significant association was found between the clinical outcomes (EQ5D3L index, EQVAS, Majeed score) and the pre-operative asymmetry value and deformity index but not the post-operative asymmetry value and deformity index. One patient (0.9 %) required revision for infection, 12 patients (10.4 %) reported post-operative lower limb paraesthesia, and one patient (0.9 %) experienced a post-operative deep vein thrombus. Conclusions: Most patients with pelvic ring injuries experienced high-energy trauma, often resulting in multiple injuries and operative interventions. Nevertheless, mortality rates were low, and most patients experienced either mild or no functional difficulties. The magnitude of the pelvic deformity pre-operatively correlates with post-operative clinical scores.
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spelling doaj-art-b5a158a5a7ed4d17a0163476aaa690f72025-08-20T03:50:21ZengElsevierSurgery in Practice and Science2666-26202025-09-012210029310.1016/j.sipas.2025.100293Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective studyGrace EM Kennedy0Ramy Rashed1Joshua Lau2Maham Khan3Mohammad Abdelmonem4Sathya Lakpriya5Bryony Ford6Ahmed El-Bakoury7Royal Devon University Healthcare NHS Foundation Trust, Barrack Road Exeter Devon, EX2 5DW, United Kingdom; Corresponding author.University Hospitals Plymouth NHS Trust, Derriford Rd, Plymouth PL6 8DH, United KingdomUniversity Hospitals Plymouth NHS Trust, Derriford Rd, Plymouth PL6 8DH, United KingdomUniversity Hospitals Plymouth NHS Trust, Derriford Rd, Plymouth PL6 8DH, United KingdomUniversity Hospitals Plymouth NHS Trust, Derriford Rd, Plymouth PL6 8DH, United KingdomUniversity Hospitals Plymouth NHS Trust, Derriford Rd, Plymouth PL6 8DH, United KingdomUniversity Hospitals Plymouth NHS Trust, Derriford Rd, Plymouth PL6 8DH, United KingdomUniversity Hospitals Plymouth NHS Trust, Derriford Rd, Plymouth PL6 8DH, United Kingdom; Alexandria University, Department of Orthopaedic Surgery and Traumatology, 22 El-Gaish Rd Al Azaritah WA Ash Shatebi, Bab Sharqi, Alexandria Governorate, 5424041, EgyptBackground and Aims: Posterior pelvic ring disruption has been associated with high-energy trauma, and significant morbidity and mortality. We aimed to determine functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries at a major trauma centre. Methods: Patients who underwent sacroiliac screw fixation at our institution, between 1st January 2013 – 1st April 2020 were identified from a database. Electronic systems were accessed to obtain information regarding patient demographics, injuries sustained, and interventions performed. Patients were contacted via telephone regarding clinical outcomes (EQ5D3L, EQVAS and Majeed scores). Radiographical outcomes were assessed using the Keshishyan cross-measure method. Results: 115 patients were identified. The mean age at injury was 51.6 years (17–84 years). Most injuries resulted from falls and road traffic collisions (83.5 %). Eighty patients (69.6 %) sustained additional non-pelvic injuries and twenty-nine (25.2 %) underwent a non-pelvic procedure, most commonly limb or clavicle fracture fixation (N = 19). Thirty-day and 12-month all-cause mortality rates were 0.9 % and 1.7 %, respectively. Clinical outcomes were obtained for 82/105 possible patients (78.1 %). Regarding EQ5D3L, 36/82 patients (43.9 %) reported a full health status; only six patients reported severe problems. The mean Majeed score was 70.3. 49/59 patients (86.0 %) returned to their pre-injury employment. A significant association was found between the clinical outcomes (EQ5D3L index, EQVAS, Majeed score) and the pre-operative asymmetry value and deformity index but not the post-operative asymmetry value and deformity index. One patient (0.9 %) required revision for infection, 12 patients (10.4 %) reported post-operative lower limb paraesthesia, and one patient (0.9 %) experienced a post-operative deep vein thrombus. Conclusions: Most patients with pelvic ring injuries experienced high-energy trauma, often resulting in multiple injuries and operative interventions. Nevertheless, mortality rates were low, and most patients experienced either mild or no functional difficulties. The magnitude of the pelvic deformity pre-operatively correlates with post-operative clinical scores.http://www.sciencedirect.com/science/article/pii/S2666262025000221Pelvic fractureSacroiliac screwPercutaneous fixationTraumaClinical outcomes
spellingShingle Grace EM Kennedy
Ramy Rashed
Joshua Lau
Maham Khan
Mohammad Abdelmonem
Sathya Lakpriya
Bryony Ford
Ahmed El-Bakoury
Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study
Surgery in Practice and Science
Pelvic fracture
Sacroiliac screw
Percutaneous fixation
Trauma
Clinical outcomes
title Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study
title_full Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study
title_fullStr Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study
title_full_unstemmed Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study
title_short Functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries: A retrospective study
title_sort functional and radiological outcomes following sacroiliac screw fixation of posterior pelvic ring injuries a retrospective study
topic Pelvic fracture
Sacroiliac screw
Percutaneous fixation
Trauma
Clinical outcomes
url http://www.sciencedirect.com/science/article/pii/S2666262025000221
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