Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, China.
Int J Surg. 2018 Feb;50:11-16. doi: 10.1016/j.ijsu.2017.12.017. Epub 2017 Dec 25.
Sacroiliac joint disruption (SJD) is a common cause of pelvic ring instability. Clinically, percutaneous unilateral S1 sacroiliac screw and anterior plating are always applied to manage SJD. The objective of this study is to elaborate their respective therapeutic traits.
Patients with SJD fixed with unilateral S1 sacroiliac screw or anterior plating from June 2011 to June 2015 were recruited into this study and were divided into two groups: group A (unilateral sacroiliac screw) and group B (anterior plating). Surgical time, blood loss, frequency of intraoperative fluoroscopy and complications were reviewed. Postoperative radiograph and CT were conducted to assess the reduction quality. Fracture healing was evaluated by radiograph performed at each follow-up. Majeed score was recorded at the final follow-up to assess the functional outcome.
Thirty-eight patients were included in group A and thirty-two patients in group B in this study. There was no significant difference in the demographic data of the two groups. A significant difference existed in the results for average operation time (P = .022) and blood loss (P = .000) between group A and group B. The mean frequency of intraoperative fluoroscopy was 15.82 in group A and 3.94 in group B (P = .000). All the fractures healed in this study. The rates of satisfactory reduction quality and functional outcome showed no significant difference between the two groups (P > .05). The complication rate was 15.79% (6/38) in group A and 9.38% (3/32) in group B (P = .660).
Compared with anterior plating, percutaneous unilateral S1 sacroiliac screw usage is less invasive; however, more intraoperative X-ray exposure and permanent neurologic damage may accompany this procedure.
骶髂关节分离（SJD）是骨盆环不稳定的常见原因。临床上，经皮单侧 S1 骶髂螺钉和前路钢板固定常用于治疗 SJD。本研究旨在详细阐述它们各自的治疗特点。
回顾性分析 2011 年 6 月至 2015 年 6 月采用单侧 S1 骶髂螺钉或前路钢板固定 SJD 的患者，将患者分为 A 组（单侧骶髂螺钉）和 B 组（前路钢板）。比较两组患者的手术时间、术中出血量、术中透视次数、并发症，术后复查 X 线片和 CT 评估复位质量，定期复查 X 线片评估骨折愈合情况，末次随访时采用 Majeed 评分评估功能恢复情况。
A 组 38 例，B 组 32 例。两组患者一般资料比较差异无统计学意义。A 组手术时间和术中出血量明显少于 B 组（P=0.022、P=0.000），A 组术中透视次数明显多于 B 组（P=0.000）。所有患者骨折均愈合。两组患者复位质量及功能恢复优良率比较差异无统计学意义（P>0.05）。A 组并发症发生率为 15.79%（6/38），B 组为 9.38%（3/32），两组比较差异无统计学意义（P=0.660）。
与前路钢板固定相比，经皮单侧 S1 骶髂螺钉固定创伤较小，但术中 X 线暴露及永久性神经损伤的风险较高。
