title: Ilio-Sacral (IS) Screw Fixation for Sacral and Sacroiliac Joint (SIJ) Injuries in Children.
abstract: BACKGROUND
  Treatment of sacral fractures and sacroiliac joint (SIJ) disruption with percutaneous ilio-sacral (IS) screw fixation had become a more popular treatment option. There has been no study that specifically assessed IS fixation in children. The purpose of this study is present our results with fixation of the sacral fractures and SIJ disruption using IS screw in children 18 years old and younger.
  
  
  METHODS
  This is a retrospective review chart for children with sacral fracture or SIJ disruption who were treated by IS fixation in the period from 2000 to 2012. The patients were assessed for the following (age, sex, type of injury, associated injuries, surgery, complications, postoperative return of function, healing of the injury, and return to function).
  
  
  RESULTS
  In the studied period (2000 to 2012), 11 patients who had either sacral fracture (4 patients) or SIJ (7 patients) disruption were treated by IS screws. The average age of these patients was 14 years (range, 6 to 17 y). Six patients had 1 screw and 5 patients had 2 screws. Eight patients had their entire fixation in S1, and 3 patients had 1 screw in S1 and 1 screw in S2. All screws were cannulated and were inserted over a guidewire with fluoroscopy and/or navigation guidance. Five patients had added anterior fixation of the pelvis. One patient was lost for follow-up. All patients (except 1) achieved healing of their injuries with no displacement or implant failure with return of function. One patient had failure of fixation and needed revision. One patient had neurological complication related to screw insertion.
  
  
  CONCLUSIONS
  IS screws can be safely used to treat sacral fractures and SIJ injuries in children. This was feasible in children as young as 6 years old. The complications of the procedure were minimal with good stability obtained by IS screws.
authors.affiliation: *Department of Orthopedic Surgery, Paul L. Foster School of Medicine, Texas Tech University Health Science Center †Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center ‡Texas Tech University Health Sciences Center of El Paso, El Paso, TX.
authors.forename: Amr A
authors.initials: AA
authors.lastname: Abdelgawad
authors.forename: Shaunette
authors.initials: S
authors.lastname: Davey
authors.forename: Jordan
authors.initials: J
authors.lastname: Salmon
authors.forename: Preet
authors.initials: P
authors.lastname: Gurusamy
authors.forename: Enes
authors.initials: E
authors.lastname: Kanlic
mesh_terms: D000293:Adolescent; D001863:Bone Screws; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012446:Sacroiliac Joint / Q000293:injuries / Q000601:surgery*; D012447:Sacrum / Q000293:injuries / Q000601:surgery*; D016103:Spinal Fractures / Q000601:surgery*