Kennedy Grace Em, Rashed Ramy, Lau Joshua, Khan Maham, Abdelmonem Mohammad, Lakpriya Sathya, Ford Bryony, El-Bakoury Ahmed
Royal Devon University Healthcare NHS Foundation Trust, Barrack Road Exeter Devon, EX2 5DW, United Kingdom.
University Hospitals Plymouth NHS Trust, Derriford Rd, Plymouth PL6 8DH, United Kingdom.
Surg Pract Sci. 2025 Jun 30;22:100293. doi: 10.1016/j.sipas.2025.100293. eCollection 2025 Sep.
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.
Patients who underwent sacroiliac screw fixation at our institution, between 1 January 2013 - 1 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.
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 ( = 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.
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.
骨盆后环损伤与高能量创伤以及显著的发病率和死亡率相关。我们旨在确定在一家大型创伤中心，骶髂螺钉固定骨盆后环损伤后的功能和影像学结果。
从数据库中识别出2013年1月1日至2020年4月1日期间在我们机构接受骶髂螺钉固定的患者。通过电子系统获取有关患者人口统计学、所受损伤和实施干预的信息。通过电话联系患者了解临床结果（EQ5D3L、EQVAS和马吉德评分）。使用凯希什扬交叉测量法评估影像学结果。
共识别出115例患者。受伤时的平均年龄为51.6岁（17 - 84岁）。大多数损伤由跌倒和道路交通事故所致（83.5%）。80例患者（69.6%）还伴有非骨盆损伤，29例（25.2%）接受了非骨盆手术，最常见的是肢体或锁骨骨折固定（n = 19）。30天和12个月的全因死亡率分别为0.9%和1.7%。82/105例可能的患者（78.1%）获得了临床结果。关于EQ5D3L，36/82例患者（43.9%）报告健康状况良好；只有6例患者报告有严重问题。马吉德评分的平均值为70.3。49/59例患者（86.0%）恢复到受伤前的工作状态。发现临床结果（EQ5D3L指数、EQVAS、马吉德评分）与术前不对称值和畸形指数之间存在显著关联，但与术后不对称值和畸形指数无关。1例患者（0.9%）因感染需要翻修，12例患者（10.4%）报告术后下肢感觉异常，1例患者（0.9%）发生术后深静脉血栓。
大多数骨盆环损伤患者经历了高能量创伤，常导致多发伤和手术干预。尽管如此，死亡率较低，大多数患者功能困难轻微或无功能困难。术前骨盆畸形程度与术后临床评分相关。
