Immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures: is it safe enough?
The purpose of this study was to compare the results of immediate and delayed percutaneous sacroiliac screws surgery for unstable pelvic fractures, regarding technical results and complication rate.
The study was conducted at the Soroka University Medical center, Beer Sheva, Israel, which is a level 1 trauma Center.
108 patients with unstable pelvic injuries were operated by the orthopedic department at the Soroka University Medical Center between the years 1999–2010. A retrospective analysis found 50 patients with immediate surgery and 58 patients with delayed surgery. Preoperative and postoperative imaging were analyzed and data was collected regarding complications.
All patients were operated on by using the same technique—percutaneous fixation of sacroiliac joint with cannulated screws.
Main outcome measurements
The study’s primary outcome measure was the safety and quality of the early operation in comparison with the late operation.
A total of 156 sacroiliac screws were inserted. No differences were found between the immediate and delayed treatment groups regarding technical outcome measures (P value = 0.44) and complication rate (P value = 0.42).
The current study demonstrated that immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures produced equally good technical results, in comparison with the conventional delayed operation, without additional complications.
KeywordsPelvic fracture Sacroiliac screw Percutaneous Early vs. late insertion
Compliance with ethical standards
No funding were received for the current study.
Conflict of interest
We Asaf Acker, Zvi Perry, Shlomo Blom, Gad Shaked and Amir Korngreen declare we have no conflict of interest.
Ethical standards statement
We hereby declare that all human and animal studies have been approved by the appropriate ethics committee and have therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
- 3.Michael D. Stove., Keith A. May., James F. Kellam, . Pelvic Ring Disruptions. In: Bruce D. Browner editor. Skeletal Trauma. 4th ed, 3rd sect., chap. 36. Elsevier’s Health Sciences, Philadelphia; 2008.Google Scholar
- 13.Pelvic ring fractures—early versus delayed fixation. Buckley Rick—Editor in chief. Orthopedic Trauma Directions 1/11, Vol 9, No 1, January 2011. Published by AO Foundation, Switzerland.Google Scholar
- 14.Routt ML Jr. Supine positioning for the placement of percutaneous sacral screws in complex posterior pelvic ring trauma. Orthop Trans. 1992;16:220.Google Scholar
- 21.Shuler TE, Boone DC, Gruen GS, et al. Percutaneous iliosacral screw fixation: early treatment for unstable posterior pelvic ring disruptions. J Orthop Trauma. 1995;38:453–8.Google Scholar