Results of treatment wi̇th percutaneous iliosacral screw i̇n the unstable posterior pelvic ri̇ng injury

Aim: In this study, the radiological and functional outcomes of patients treated with iliosacral screw in pelvic instability posterior ring injuries and the factors affecting the results were evaluated. Material and Method: 43 patients who have pelvic instabil posterior ring injury and treated with iliosacral screw were examined retrospectively between 2011 and 2017, at Department of Orthopedics and Traumatology, Faculty of Medicine, Dicle University. 38 patients with adeguate clinical and radiological follow-up were also studies. The radiological evaluation of the patients was performed by preoperative and postoperative computed tomography as described by Henderson, pelvis a-p and inlet radiography, and functional outcomes were based on Majeed scoring. Results: Twenty-six (68,4%) of the cases were male and 12 (31.6%) were female. The mean age was 33,7 (15–68) years, followed by 41,5 (12–75) months. According to tile classification; 28 (73,7%) were Type B, 10 (26,3%) were Type C. The mean of duration of surgery was 2,5 (1–10) days. A total of 54 screws were used in 38 patients. 23 (60,5%) patients had a screw to S1, 1 (2,6%) to S2 screw, 12 (36,8%) patients were used screws to both S1 and S2 and 2(%5,2) cases, total of 3 screws were used in S1 and S2. The mean of preoperative vertical displacement was measured 4.87 ± 3,2 (0–14.4) mm, postoperative early stage vertical displacement was measured as 2,16 ± 1,94 mm (0–8) mm, late-stage vertical displacement was measured as mean 2,17 ± 2,11 (0–9) mm. Preoperative posterior displacement was 7.02 ± 2.84 (3–14) mm, postoperative early posterior displacement was 2.94 ± 2.39 (0–8) mm, the mean of late displacement was 3.03 ± 2.43 (0–8) mm. The mean Majeed functional score of the patients was 84,7 ± 10,5 (56–97). Functional scores of the patients in 22 (55,3%) of the patients were evaluated as excellent. Twelve (31,5%) of the patients evaluated well, and 4 (10,5%) of the patients the middle and were evaluated moderate. Additional fracture and organ pathology, age, number of screws used and sex did not affect functional and radiological results. Concusion: The iliosacral screw application inpelvic instabil posterior ring injuries is a method that can be applied early in hemodinamically unstable patients with good radiological and functional results and few complications. Key Words: pelvic injury, posterior ring, instability, surgical treatment, iliosacral screw