Effect of sacral reduction quality on postoperative clinical outcomes in Tile C1.3 pelvic fractures
Objective:To evaluate the effect of sacral reduction quality on postoperative clinical outcomes in Tile C1.3 pelvic fractures.Methods:A retrospective analysis was conducted on the clinical data of 97 patients with Tile C1.3 pelvic fractures treated at Honghui Hospital Affiliated to Xi'an Jiaotong University from June 2016 to June 2021.Patients were divided into two groups based on postoperative CT for assessing the reduction quality:a good sacral reduction group with a postoperative sacral displacement≤1 cm(42 cases)and a poor sacral reduction group with sacral displacement>1 cm(55 cases).The Gibbons classification system was used to assess postoperative sacral nerve injury,the Majeed score was used to evaluate pelvic functional post-surgery,and the Visual Analog Scale(VAS)was utilized to assess postoperative pain levels.At the last follow-up,X-rays were used to evaluate the failure of internal fixation devices,and CT scans were performed one year postoperatively to assess the degree of sacral nonunion.Results:All patients were followed up for 24 to 47 months,with an average follow-up of(35.7±5.3)months.There was no statistically significant difference in the Gibbons classification scores for sacral nerve injury between the two groups before and after surgery(all P>0.05).The good sacral reduction group had a better Majeed score,with a rate of 83.3%(35/42),which was significantly greater than the 58.2%(32/55)in the poor sacral reduction group(χ2=16.668,P=0.001).There was a significant difference in the postoperative pain between the two groups(Z=-2.787,P=0.003).At the last follow-up,the failure rate of internal fixation was 7.1%(3/42)in the good sacral reduction group,which was significantly lower than the 27.3%(15/55)in the poor sacral reduction group(χ2=6.385,P<0.05).One year postoperatively,sacral nonunion occurred in 14.5%(8/55)of the poor sacral reduction group,compared to 0%in the good sacral reduction group(P<0.05).Conclusions:In patients with Tile C1.3 pelvic fractures,sacral displacement>1 cm is associated with significantly worse postoperative pelvic function,as evidenced by increased lumbosacral pain,a greater risk for internal fixation failure and sacral nonunion compared to those with sacral displacement≤1 cm.
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