Mehmet Bulut1*, Fırat Tantekin M1, Serdar Yalvaç E2, Onur Ziyadanoğulları M3, Murat Gürger4, Akif Çaçan M5 and Emin Özkul1
1Department of Orthopaedics and Traumatology, Dicle University, Turkey
2Department of Orthopaedics and Traumatology, Yozgat Boğazlıyan State Hospital, Turkey
3Department of Orthopaedics and Traumatology, Diyarbakır Çermik State Hospital, Turkey
4Department of Orthopaedics and Traumatology, Fırat University, Turkey
5Department of Orthopaedics and Traumatology, Medipol School of Medicine, Turkey
Purpose: In this study, we evaluated the radiological and functional results of the patients treated with iliosacral screw in the unstable posterior ring injuries of the pelvis and the factors affecting the results.
Materials and Methods: 43 patients, who were treated due to instable posterior ring injury of the pelvis in Dicle University, Faculty of Medicine, Department of Orthopedics and Traumatology between 2014 and 2017, were evaluated retrospectively. 38 patients with adequate clinical and radiological follow-ups were included in the study. Reduction maneuvers were performed before fixation. The inlet and outlet angles were calculated for all cases in the sagittal plane of Computed Tomography (CT). Radiological evaluation of the patients was performed by preoperative and postoperative computed tomography, pelvic anterior-posterior and inlet images according to Henderson's descriptions, and evaluation of the functional results according to Majeed scoring.
Results: 26 (68.4%) of the cases were male and 12 (31.6%) were female, mean age was 33.7 (15-68) years, mean follow-up time was 36.5 (12-58) months. 28 (73.7%) of the patients were Tile Type B and 10 (26.3%) were Tile Type C. The average time between injury and surgery was 2.5 (1-10) days. A total of 54 screws were used in 36 patients. The mean preoperative vertical displacement was 4.87 ± 3.2 (0-14.4) mm preoperatively, 2.16 ± 1.94 (0-8) in postoperative early period, and 2.17 ± 2.11 (0-9) at the last follow-up. The mean anteroposterior displacement was 7.02 ± 2.84 (3-14) mm preoperatively, 2.94 ± 2.39 (0-8) in postoperative early period and 3.03 ± 2.43 (0-8) at the last followup. The mean Majed functional score at the final follow-up was 84.7 ± 10.5 (56-97). The results were excellent in 22 (57.8%) patients, good in 12 (31.5%) and moderate in 4 (10.5%) patients. Age, gender, additional fracture and organ pathology did not affect the number of screws used and the functional and radiological results (p>0.05).
Conclusion: Iliosacral screw application is a method, in which radiological and functional results are good and complications are low, and can be applied in early period, especially in hemodynamically unstable patients. The most important points of the method are the reduction before the fixation and the taking inlet-outlet images at the right angles.
Pelvis injury; Posterior ring; Instability; Inlet-outlet image; Iliosacral screw
Bulut M, Fırat Tantekin M, Serdar Yalvaç E, Onur Ziyadanoğulları M, Gürger M, Akif Çaçan M, et al. The Results of Treatment with Percutan Iliosacral Screw in Posterior Ring Injuries of Pelvis and the New Method for Measuring Inlet-Outlet Angle. Ann Orthop Surg Res. 2019; 2(1): 1006.