Analysis of the functional results of patients with unstable pelvis posterior ring injuries treated with open reduction internal fixation or iliosacral screw fixation in our clinic

In this study, we aimed to restrospectively analyse the functional results of patients presenting to our clinic with unstable pelvic posterior ring injuries and were treated using open reduction internal fixation or using closed reduction percutaneous iliosacral screw fixation between years 2011 and 2023. Patient epicrisis, outpatient clinic follow-up cards, computer records, preoperative and postoperative follow-up radiographs were obtained from the archive records and the hospital database. Criteria for inclusion of patients in the study was determined as having an unstable pelvic posterior ring injury, having been operated in our clinic, being followed up on for at least 12 months postoperatively, accessibility to the patient file and radiological imaging, having valid contact information, and consenting to take part in the study. 84 patients who met these criteria were included in the study. The clinical and radiological results were compared between patients who underwent open reduction internal fixation and patients who underwent closed reduction percutaneous iliosacral screw fixation. The functional results of the patients were evaluated with the Majeed functional scoring system. Using the most recent follow-up radiographs of the patients, the amount of vertical displacement was evaluated with the method described by Matta and the amount of anterior-posterior displacement was evaluated with the method described by Henderson. Despite Majeed functional scores being significantly higher in the KRPIV group, there were no significant difference between radiological results of the two surgical methods. When KRPIV and ARIF methods were compared in posterior pelvic ring fixation, it was observed that the duration of the operation, the lenght of postoperative hospital stay and the amount of peroperative bleeding were significantly lower in the KRPIV group. As a result, both methods can be considered valid surgical techniques for posterior pelvic ring injuries. Method selection should be done according to the type of fracture, the clinical condition of the patient and the surgical experience. Key words: Posterior pelvic ring, fracture fixation, functional outcome