• Felix Karl-Ludwig Klingebiel, Yannik Kalbas, Octavia Klee, Anhua Long, Michel Teuben, Henrik Teuber, Sascha Halvachizadeh, Till Berk, Valentin Neuhaus, Hans-Christoph Pape, and Roman Pfeifer.
• Department of Trauma Surgery, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland. FelixKarl-Ludwig.Klingebiel@usz.ch.
• Eur J Trauma Emerg Surg. 2024 Aug 27.

PurposeThe emergency treatment of unstable pelvic ring injuries is still a challenge and requires surgical and anesthesiological resuscitation. Emergency fixation of the unstable pelvic ring with percutaneous sacroiliac (SI) screws, also known as "Rescue Screws", is an established treatment method. The aim of our study was to compare the outcome and complication rates of "Rescue Screws" with elective SI-screw fixations.MethodsA 1:1 ratio nearest-neighbor matched, retrospective cohort study of trauma patients with acute pelvic ring injuries at a level one trauma center was performed. Patients ≥ 15 years, treated with SI-screw fixation were included.Exclusion Criteriapathologic fractures, missing consent and navigated procedures. The primary outcome parameters was defined as SI-screw revision operations. Patients were stratified according to treatment strategy (RS: Rescue Screws; EL: elective SI-screws).ResultsFrom 392 patients identified between 11/2014 and 08/2021, 186 met the inclusion criteria with 41 in the RS Group and 145 in the EL group. After matching, 41 patients were included in each group with similar baseline characteristics except persistent hemodynamic shock (RS: n = 22 (53.37%) vs. EL: n = 1 (4.3%), p < 0.001). Surgical characteristics were comparable in terms of instrumentation levels and insertion-sites. No significant differences were observed in the outcome parameters (revisions, reoperations, implant-associated complications, LOS and mortality) between both groups.ConclusionTreatment of unstable pelvic ring fractures with Rescue Screws appears as a feasible treatment option for emergency stabilization. Rescue Screws are not associated with elevated revision rates and increased complications rates. This minimally invasive technique enables safe emergency stabilization of the posterior pelvic ring. Prospective or randomized clinical trials are required to directly compare Rescue Screws with other competing emergency stabilization techniques.© 2024. The Author(s).

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