Abstract
Introduction We report on the clinical and radiological outcomes and complications associated with percutaneous ilio-sacral screw fixation of the pelvis.
Methods Patients were located on the plevic data base held at Frenchay Hospital, Bristol, UK. Patient charts were reviewed and their clinical outcomes had been determined using a visual analogue (VAS) pain score. All patients had pre and post-operative x-rays and CT scans. These were used to determine fracture type and subsequent post-operative reduction. All complications and subsequent surgery required was noted.
Results One hundred and seven patients with 76 disruptions of the sacro-iliac joint and 62 sacral fractures treated with percutaneous ilio-sacral screws were reviewed. Average follow-up was 2.5 years (range 6 months to 8 years). Half of the patients had a VAS score of zero post-operatively, 30% had scores of one to five and 20% had scores of greater than five. The majority of these patients had a coexisting neurological lesion. Seventy-one percent had an anatomical reduction (within 5 mm), 18% had displacements of between five and 10 mm and 11% had displacements of greater than 10 mm. There were five infections, four sacral nonunions, four failures of fixation and one case of a transient L5 nerve plasy following inadvertent screw positioning.
Conclusions Percutaneous ilio-sacral screw fixation of the pelvis allows safe, reliable and accurate reduction. Poor clinical results are often attributable to coexisting neurological lesions.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
