title: Isolated pelvic ring injuries: functional outcomes following percutaneous, posterior fixation.
abstract: OBJECTIVE
  To characterize pelvic-specific functional outcomes in patients with isolated, partially unstable (AO/OTA 61-B), pelvic ring injuries treated with posterior only percutaneous screw fixation of the pelvic ring.
  
  
  METHODS
  Between September 2007 and October 2011, 16 subjects (mean age 42.4 years; range 18-90 years) with isolated, partially unstable pelvic ring injuries (AO/OTA 61-B) were treated with percutaneous, posterior pelvic ring fixation. Subjects underwent an evaluation of pelvic ring function with a modification of Majeed's pelvic functional outcome assessment tool. Subjects were excluded if they sustained a concomitant long-bone fracture, visceral injury requiring surgery, spinal cord injury, and an injury to the anterior pelvic ring or acetabulum requiring additional fixation.
  
  
  RESULTS
  Mean follow-up was 30.8 (range 14-55) months. Eleven subjects sustained unilateral posterior ring injuries, and five subjects sustained bilateral posterior ring injuries. All fractures healed uneventfully, and no hardware failures were noted. Average pelvic functional outcome score at final follow-up was 85.3 % (good). All but subjects required assistive walking devices and gait and sitting comfort scored "excellent." High rates of sexual dysfunction and persistent difficulty with daily activities were noted in this series.
  
  
  CONCLUSIONS
  This series demonstrates that activity-specific dysfunction persists years after definitive percutaneous posterior fixation of isolated pelvic ring injuries. Radiographic outcomes were excellent as were subjects' ability to ambulate independently and sit comfortably without pain. Many complained of persistent discomfort with both daily activities and sexual activity, suggesting persistent pathology to the non-osseous structures about the pelvis.
authors: Department of Orthopaedic Surgery, University of Pennsylvania, 3737 Market Street, 6th Floor, Philadelphia, PA, 19104, USA, msulli96@gmail.com.
authors: Matthew P
authors: MP
authors: Sullivan
authors: John A
authors: JA
authors: Scolaro
authors: Andrew H
authors: AH
authors: Milby
authors: Samir
authors: S
authors: Mehta
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010147:Pain Measurement; D017060:Patient Satisfaction; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery; D017699:Pelvic Pain / Q000209:etiology / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult