title: The Effect of Transiliac-Transsacral Screw Fixation for Pelvic Ring Injuries on the Uninjured Sacroiliac Joint.
abstract: OBJECTIVE
  To evaluate the functional outcomes and pain in patients with unilateral posterior pelvic ring injuries treated with transiliac-transsacral screw fixation compared with unilateral iliosacral screw fixation.
  
  
  METHODS
  Retrospective comparative study.
  
  
  METHODS
  Three academic level 1 trauma centers.
  
  
  METHODS
  From a group of 866 patients with pelvic ring injuries treated surgically, 86 patients with unilateral pelvic ring injuries treated with transiliac-transsacral screws and 97 patients treated with unilateral iliosacral screws were identified. Thirty-six patients treated with transiliac-transsacral fixation and 26 patients treated with unilateral iliosacral screws met the inclusion criteria and participated.
  
  
  METHODS
  Patients were treated surgically for unstable pelvic ring injuries with either unilateral iliosacral screws or transiliac-transsacral screws at the discretion of the treating surgeon.
  
  
  METHODS
  Majeed Pelvic Score.
  
  
  RESULTS
  There was no significant difference in Majeed Pelvic Scores between patients treated with transiliac-transsacral screws and those treated with unilateral iliosacral screws (72.8 ± 23.7 vs. 70.4 ± 19.0, P = 0.66). There was no difference in side-specific Numeric Rating Scale pain scores between patients treated with transiliac-transsacral screws and those treated with unilateral iliosacral screws on the injured side (2.5 ± 3.1 vs. 2.0 ± 2.4, P = 0.46) or the uninjured side (1.7 ± 2.8 vs. 0.8 ± 1.7, P = 0.12). Mean follow-up was greater than 3 years with no difference between the groups (mean 1270 vs. 1242 days, P = 0.84).
  
  
  CONCLUSIONS
  Treatment of unilateral pelvic ring injuries with transiliac-transsacral screws does not adversely affect or improve patient outcomes or subjective pain scores when compared with those treated with unilateral iliosacral screws.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Departments of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO; †Departments of Orthopaedic Surgery, University of Utah, Salt Lake City, UT; and ‡Departments of Orthopaedic Surgery, Stanford University, Palo Alto, CA.
authors.forename: Sami W
authors.initials: SW
authors.lastname: Mardam-Bey
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Beebe
authors.forename: James C
authors.initials: JC
authors.lastname: Black
authors.forename: Ellen Y
authors.initials: EY
authors.lastname: Chang
authors.forename: Erik N
authors.initials: EN
authors.lastname: Kubiak
authors.forename: Julius A
authors.initials: JA
authors.lastname: Bishop
authors.forename: Christopher M
authors.initials: CM
authors.lastname: McAndrew
authors.forename: William M
authors.initials: WM
authors.lastname: Ricci
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Gardner
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D001863:Bone Screws / Q000706:statistics & numerical data; D015984:Causality; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012446:Sacroiliac Joint; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology