Open Reduction Internal Versus Percutaneous Sacroiliac Screw Fixation in Unstable Posterior Ring Injury of Pelvic

• Conditions: Orthopedic Disorder
• Interventions: Procedure: closed reduction percutaneous fixation with open reduction internal fixation of the posterior pelvic ring

• Registration Number: NCT05473611
• Lead Sponsor: Ataturk University

Brief Summary

Surgical trearment of unstable posterior pelvic injuries can be performed with open reduction and internal fixation, closed reduction with percutaneous sacroiliac fixation. Biomechanically, no significant difference was found between the two methods in the literature. The aim of our study is to compare the radiological and clinical functional results of these methods.

Detailed Description

Pelvic injuries are usually encountered in patients with polytrauma. These are injuries that need to be treated with a multidisciplinary approach. The primary approach is to stabilize the patient hemodynamically. Mortality rate in pelvic injuries reaches 10-20%.

The pelvis has a ring-shaped structure. It is the sacrum that transfers the load from the lower extremities to the axial spine from this structure. The joint between the sacrum and the ilium, that is, the joint that is exposed to the load, is the sacroiliac joint. For this reason, surgical treatments have been developed to stabilize the posterior pelvic ring, to mobilize the patient as soon as possible, to walk in a balanced way without leg length difference, to prevent loss of work force, and to shorten the hospitalization period. Open reduction internal fixation and closed reduction percutaneous sacroiliac screw fixation surgical methods have been described to ensure the stability of the posterior pelvic ring In this study, we evaluated the radiological and functional results of patients with posterior pelvic ring injuries stabilized by open and closed surgical approaches; We have compiled and summarized the current literature on pelvic injuries. We aimed to contribute to the literature by sharing our knowledge and findings about these difficult, complex and prone surgical techniques.

marks of conformity

1. Surgical intervention for sacroiliac joint fracture-dislocation

2. 18-65 years old patient

3. Patients who come to clinical follow-ups for at least 6 months

Study Timeline

• Study Start: 2022-03-10
• Study First Submitted: 2022-07-22
• Study First Submitted QC: 2022-07-22
• Study First Posted: 2022-07-26
• Status Verified: 2022-08
• Last Update Submitted: 2022-08-03
• Last Update Posted: 2022-08-05
• Primary Completion: 2022-11-10
• Study Completion: 2023-03-12

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

• Surgical intervention for sacroiliac joint fracture-dislocation
• 18-65 years old patient
• Patients who come to clinical follow-ups for at least six months
• not paralyzed

Exclusion Criteria

• Patients under 18 years of age
• Patients older than 65 years
• Patients who did not come for their follow-up in our clinic
• paralyzed patients
• mentally retarded patients

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
closed reduction percutaneous fixation method	closed reduction percutaneous fixation with open reduction internal fixation of the posterior pelvic ring	Patients with closed reduction percutaneous sacroiliac screw fixation of posterior pelvic ring due to unstable pelvic injury
open reduction anterior sacroiliac approach	closed reduction percutaneous fixation with open reduction internal fixation of the posterior pelvic ring	Patients with fixation of the posterior pelvic ring by open reduction anterior approach due to unstable pelvic injury
open reduction posterior sacroiliac approach	closed reduction percutaneous fixation with open reduction internal fixation of the posterior pelvic ring	Patients with fixation of the posterior pelvic ring by open reduction posterior approach due to unstable pelvic injury

Primary Outcome Measures

Name	Time	Method
functional scoring	at least 6 months	Grading of outcomes using the clinical functional scoring system for pelvic injuries defined by Majeed
radiological scoring	at least 6 months	Radiological grading of the treatment process of pelvic fracture with the measurement methods of pelvic plain radiographs defined by Matta and Henderson

Trial Locations

Locations (1)

Ataturk University Faculty of Medicine; 🇹🇷 Erzurum, Yakutiye, Turkey