Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075, Göttingen, Germany.
Department of Trauma and Orthopaedics, North Bristol NHS Trust, Southmead Hospital, Southmead Rd, Bristol, BS10 5NB, UK.
Eur J Trauma Emerg Surg. 2022 Apr;48(2):1491-1498. doi: 10.1007/s00068-020-01504-z. Epub 2020 Sep 30.
Reduction and percutaneous screw fixation of sacroiliac joint disruptions and sacral fractures are surgical procedures for stabilizing the posterior pelvic ring. It is unknown, however, whether smaller irregularities or the inability to achieve an anatomic reduction of the joint and the posterior pelvic ring affects the functional outcome. Here, the long-term well-being of patients with and without anatomic reduction of the posterior pelvis after sacroiliac joint disruptions is described.
Between 2011 and 2017, 155 patients with pelvic injuries underwent surgical treatment. Of these, 39 patients with sacroiliac joint disruption were examined by radiological images and computer tomography (CT) diagnostics and classified according to Tile. The functional outcome of the different surgical treatments was assessed using the short form health survey-36 (SF-36) and the Majeed pelvic score.
Complete data sets were available for 31 patients, including 14 Tile type C and 17 type B injuries. Of those, 26 patients received an anatomic reduction, 5 patients obtained a shift up to 10 mm (range 5-10 mm). The SF-36 survey showed that the anatomic reduction was significantly better in restoring the patient's well being (vitality, bodily pain, general mental health and emotional well-being). Patients without this treatment reported a decrease in their general health status.
Anatomic reduction was achieved in over 80% of patients in this study. When comparing the long-term well-being of patients with and without anatomic reduction of the posterior pelvis after sacroiliac joint disruptions, the results suggest that anatomical restoration of the joint is beneficial for the patients.
骶髂关节脱位和骶骨骨折的复位和经皮螺钉固定是稳定骨盆后环的手术方法。然而，目前尚不清楚关节和骨盆后环的解剖复位是否会影响功能结果，是否存在较小的不平整或无法实现关节和骨盆后环的解剖复位。在此，描述了骶髂关节脱位患者在骨盆后环解剖复位和未解剖复位后的长期健康状况。
2011 年至 2017 年间，155 例骨盆损伤患者接受了手术治疗。其中，39 例骶髂关节脱位患者接受了影像学和计算机断层扫描（CT）诊断，并根据 Tile 分类进行分类。使用简短形式健康调查-36（SF-36）和 Majeed 骨盆评分评估不同手术治疗的功能结果。
31 例患者（包括 14 例 Tile 型 C 和 17 例 B 型损伤）的完整数据集可用。其中，26 例患者接受了解剖复位，5 例患者获得了 5-10mm 的移位（范围 5-10mm）。SF-36 调查显示，解剖复位在恢复患者的健康状况（活力、身体疼痛、一般心理健康和情绪健康）方面明显更好。未接受这种治疗的患者报告其整体健康状况下降。
在本研究中，超过 80%的患者实现了解剖复位。当比较骶髂关节脱位患者骨盆后环解剖复位和未解剖复位后的长期健康状况时，结果表明关节的解剖复位对患者有益。
