Immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures: is it safe enough?

Objectives: The purpose of this study was to compare the results of immediate and delayed percutaneous sacroiliac screws surgery for unstable pelvic fractures, regarding technical results and complication rate. Design: Retrospective study. Setting: The study was conducted at the Soroka University Medical center, Beer Sheva, Israel, which is a level 1 trauma Center. Patients: 108 patients with unstable pelvic injuries were operated by the orthopedic department at the Soroka University Medical Center between the years 1999–2010. A retrospective analysis found 50 patients with immediate surgery and 58 patients with delayed surgery. Preoperative and postoperative imaging were analyzed and data was collected regarding complications. Intervention: All patients were operated on by using the same technique—percutaneous fixation of sacroiliac joint with cannulated screws. Main outcome measurements: The study’s primary outcome measure was the safety and quality of the early operation in comparison with the late operation. Results: A total of 156 sacroiliac screws were inserted. No differences were found between the immediate and delayed treatment groups regarding technical outcome measures (P value = 0.44) and complication rate (P value = 0.42). Conclusions: The current study demonstrated that immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures produced equally good technical results, in comparison with the conventional delayed operation, without additional complications.