Anatomic reduction of the sacroiliac joint in unstable pelvic ring injuries and its correlation with functional outcome
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ORIGINAL ARTICLE
Anatomic reduction of the sacroiliac joint in unstable pelvic ring injuries and its correlation with functional outcome Katharina Jäckle1 · Christopher Spering1 · Mark‑Tilmann Seitz1 · Sebastian Höller1 · Marc‑Pascal Meier1 · Franziska Melanie Hahn1 · Mehool R. Acharya2 · Wolfgang Lehmann1 Received: 27 July 2020 / Accepted: 15 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose 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. Methods 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. Results 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. Conclusions Anatomic reduction was achieved in over 80% of patients in this study. When comparing the long-term wellbeing 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. Keywords Sacroiliac joint fractures · Sacroiliac joint disruptions · Anatomic reduction · Percutaneous screw fixation · Long-term outcome Abbreviations BP Bodily pain CT Computer tomography EWB Emotional well-being GH General health perceptions ICD International classification of diseases MH General mental health Katharina Jäckle and Christopher Spering have contributed equally to this work and therefore share first authorship. * Wolfgang Lehmann [email protected]‑goettingen.de 1
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
2
NRS Numerical rating scale N. s. Not significant OPS Operations and procedures key PF Physical functioning RE Role limitat
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