Alba Shehu (Zurich / CH), Felix Karl Ludwig Klingebiel (Zurich / CH), Michel Paul Johan Teuben (Zurich / CH), Octavia Klee (Zurich / CH), Yannik Kalbas (Zurich / CH), Anhua Loong (Zurich / CH), Henrik Teuber (Zurich / CH), Valentin Neuhaus (Zurich / CH), Ladislav Mica (Zurich / CH), Hans-Christoph Pape (Zurich / CH), Roman Pfeifer (Zurich / CH)
Abstract text (incl. references and figure legends)
Introduction
Lateral compression (LC) fractures are the commonest pelvic ring injury. Sacroiliac (SI) screws are used for posterior pelvic ring stabilization. Dual SI-screw stabilization (S1 plus S2) is associated with superior biomechanical properties compared with single SI-screw-stabilizations (S1-only). The current study aimed to compare functional outcome of single and dual SI-screws for LC-fractures.
Material&Methods
A retrospective study of patients treated with SI-screw stabilization of traumatic LC-fractures at a level 1 trauma center was performed. Patients were grouped based on applied treatment modality (Gr. S1: S1-screw only vs. Gr. Dual: S1 and S2-screws). Clinical and functional outcome were compared.
Results
93 patients have been included. Groups had similar patient and trauma characteristics and a pooled ISS of 18 was found. Gr. S1 consisted of 19 patients, whereas Gr. Dual included 74 individuals. LC-1 fractures were diagnosed most frequently (N=46), 38 patients had LC-2 fractures and 9 patients had LC-3 injuries. Screw loosening/malpositioning/breakage and reoperation rates did not differ between groups. Equal hospitalization times were found as well: Gr. S1: 17(10) days vs. 15 (10) days in Gr. Dual (P=0.41). At discharge, the ability to sit/stand independently did not differ (respectively: Gr. S1: 83/17% vs. Gr. Dual: 71/28%, P= 0.41/0.55. Significantly more patients from the Dual-group were discharged home than from the S1-group (28% vs. 5%, P=0.002).
Conclusion
This study shows that both single S1 and dual (S1 and S2) percutaneous SI-screw fixation for LC-fractures are feasible treatment options. Hardware-related complications as well as functional outcome are very similar. Interestingly, dual screw-fixation is associated with more discharge to home. Future studies should focus on the identification of patients who benefit most from single or dual SI-screw stabilizations.
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