• Sami W Mardam-Bey, Michael J Beebe, James C Black, Ellen Y Chang, Erik N Kubiak, Julius A Bishop, Christopher M McAndrew, William M Ricci, and Michael J Gardner.
• *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.
• J Orthop Trauma. 2016 Sep 1; 30 (9): 463-8.

ObjectiveTo 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.DesignRetrospective comparative study.SettingThree academic level 1 trauma centers.Patients/ParticipantsFrom 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.InterventionPatients were treated surgically for unstable pelvic ring injuries with either unilateral iliosacral screws or transiliac-transsacral screws at the discretion of the treating surgeon.Main Outcome MeasurementMajeed Pelvic Score.ResultsThere 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).ConclusionsTreatment 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.Level Of EvidenceTherapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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