title: Percutaneous iliosacral screw fixation after osteoporotic posterior ring fractures of the pelvis reduces pain significantly in elderly patients.
abstract: BACKGROUND
  Osteoporotic posterior ring fractures of the pelvis are common injuries in the elderly, but the treatment of these fractures still remains controversial. Percutaneous iliosacral screw fixation is one surgical option if conservative treatment cannot provide sufficient pain reduction. The aim of this study is to provide short-term results of elderly patients with percutaneous screw fixation.
  
  
  METHODS
  30 patients with posterior ring fractures were treated between 12/2009 and 01/2014 with percutaneous iliosacral screw fixation. Patients' mean age was 78.4 years. Concerning short-term outcome, we focused on initial pain level and postoperative pain reduction together with intra- and postoperative complications.
  
  
  RESULTS
  The average hospital stay was 23.7 days, with surgical treatment performed after an average of 9.2 days. 90% of our patients were female. All 30 patients had a lower level of pain at discharge compared with admission or immediately prior to surgery. The difference in pain level at admission compared with the pain level upon discharge showed a mean reduction from 6.8 to 1.8 with a statistically significant change (P≤0.001). 24 of 30 patients had no registered complications, one screw malpositioning with postoperative nerve irritation occurred.
  
  
  CONCLUSIONS
  Conventional percutaneous iliosacral screw fixation is a successful operative treatment for elderly patients with persistent lower back pain after unstable posterior ring fractures of the pelvis. Intra- and postoperative complications are rare, so this treatment can be regarded as a safe procedure.
  
  
  METHODS
  IV (retrospective study).
authors.affiliation: St. Elisabeth Hospital, Werthmannstraße 1, 50935 Cologne, Germany. Electronic address: Johannes.hopf@t-online.de.
authors.forename: Johannes Christof
authors.initials: JC
authors.lastname: Hopf
authors.affiliation: St. Elisabeth Hospital, Werthmannstraße 1, 50935 Cologne, Germany.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Krieglstein
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitsklinikum Köln, Kerpener Straße 62, 50937 Cologne, Germany.
authors.forename: Lars P
authors.initials: LP
authors.lastname: Müller
authors.affiliation: St. Elisabeth Hospital, Werthmannstraße 1, 50935 Cologne, Germany.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Koslowsky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D050723:Fractures, Bone / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000601:surgery; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D010384:Pelvic Bones / Q000293:injuries*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012446:Sacroiliac Joint / Q000503:physiopathology / Q000601:surgery*; D012447:Sacrum / Q000601:surgery
keywords: Osteoporotic pelvic ring fractures; Percutaneous iliosacral screw fixation