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General Orthopaedics

FUNCTIONAL OUTCOME SCORES OF PERCUTANEOUS SI SCREW FIXATION OF TILE TYPE C FRACTURES USING THE MAJEED AND IOWA PELVIC SCORES

Combined Irish Orthopaedic Association, Welsh Orthopaedic Association, Scottish Orthopaedic Association (IOA, WOA, SOA)



Abstract

Objective

To report clinical results of patients who underwent closed reduction and percutaneous iliosacral screw fixation for Tile Type C fractures.

Materials and Methods

Retrospective, we collected data using medical records and images of patients treated in our centre. Prospectively, we followed up patients with two questionnaires. Minimum follow up time was 12 months with the mean being 24 months. 36 patients were followed up with a mean age 34 years (range 14- 65) from 2001-2009. Fracture types included 1 C1-1, 18 C1-2, 26 C1-3. Functional status was assessed using the Majeed pelvic score and the Iowa pelvic Score.

Results

Types of injury included 38% road traffic accidents, 16% pedestrians hit by a car, 11% crush injuries, 11% falls from a significant height (>10ft),and 9% forklift injury. 32% of injuries occurred at work. The most commonly associated injury was pubic rami fractures closely followed by spinal injury and femoral fractures. The average Majeed score for those unemployed, pre injury, was 68 (good) and those employed was 67 (fair). The average Iowa score was 71 (good). 36% of patients returned to work, 36% were unable to return to work, 4% retired and, 22% were unemployed pre and post injury. The average visual pain score was 3.9/10 and 20% of patients experience no pain.

Surgical complications included 2 non unions requiring open reduction and internal fixation, and 1 wound infection requiring removal of metalwork. Three patients required removal of metalwork due to ongoing back pain, of these 2 patients symptoms improved.

Conclusion

Our patients experienced a low rate of complications and had a good functional outcome after undergoing closed reduction and percutaneous iliosacral fixation for Tile Type C fractures.