Long-term functional outcomes of patients with sacroiliac joint dislocation or crescent fracture after surgical treatment

Objective: In this study, it was aimed to evaluate the long-term clinical and radiological results of surgical treatment of patients with crescent fractures or dislocation of the sacroiliac joint. Methods: 850 patients with pelvic injuries treated between 2000-2020 in İnönü University, Faculty of Medicine, Department of Orthopedics and Traumatology were evaluated retrospectively. Among these, 110 patients with sacroiliac joint injury and crescent fracture treated with iliosacral screw and/or plate were included in the study. Patients were evaluated using subjective pelvic symptom scoring at their final follow-up. The results of the patients were classified as very good, good, moderate or bad according to their scores. For statistical evaluation, IBM SSPS (İnternational Business Machine Statistical Package for the Social Sciences) statistics 26.0 package program was used. In descriptive statistical analyses, mean ± standard deviation and median (minimum-maximum) for continuous variables; numbers and percentages were given for categorical variables. Chi-square test was used to compare categorical data. Statistical significance level was accepted as p<0.05. Results: The mean age of the patients at the time of injury was 35.15±17.09 (minimum 6-maximum 80). 74 (67.3%) of the patients were male and 36 (32.7%) of them were female. The most common cause of injury was found to be in-vehicle traffic accident with 35.5%. Fracture type was OTA Type B2 in 50.9% of the patients. 48.2% of the patients had additional orthopedic injuries and 40.9% of them had additional organ injuries. Functional scoring results were excellent in 47.9%, good in 38.2%, moderate in 12.7%, and poor in 1.8% of the patients. There was no statistically significant difference between the functional scoring results of patients treated with sacroiliac ORIF plate method, sacroiliac closed reduction percutaneous screw therapy and both treatments (p>0.05). In addition, no significant difference was observed among different treatment groups (anterior or posterior ORIF /w plate and screws, closed reduction /w percutaneus iliosacral screw) (p>0.05). Conclusions: In our study, it was demonstrated that satisfactory functional results were obtained with appropriate surgical treatment in patients with crescent fracture and sacroiliac joint dislocation. Keywords: Crescent fracture, pelvic fracture, sacroiliac joint injury