Risk Factors for Screw Loosening After Sacroiliac Screw Treating Posterior Pelvic Ring Fracture
CHEN Yu
WANG Guodong
ZHOU Wei
QIAN Shenglong
BAO Suyaolatu
XIONG Ziren
FAN Le
LIU Ximi-ng
Abstract：Objective To analyze the influencing factors of screw loosening after iliosacral joint screw fixation for posterior pelvic ring injury.Methods The data of 163 patients who underwent iliosacral joint screw fixation in the de-partment of orthopedics of author's hospital from July 2015 to July 2023 were retrospectively analyzed,and the patients were divided into screw loosening group(n=22)and screw non-loosening group(n=141).Demographic and surgical variables including age,sex,Young-Burgess classification,Denis classification,screw type,insertion zone,insertion di-rection,times of insertion track adjustments,osteoporosis self-assessment tool for Asians(OSTA)indexes,fracture re-duction status,whether the anterior pelvic ring was fixed or not and whether it was combined with crescent fracture of pa-tients were compared between two groups,multivariate Logistic regression analysis was used to analyze the risk factors of postoperative screw loosening.Results All the 163 patients were followed up for 12-48(16.80±6.15)months.Com-pared with the screw non-loosening group,the OSTA indexes of the patients in screw loosening group decreased,the proportions of Young-Burgess classification was VS pelvic fracture,the Denis classification involved zone Ⅱ,common screw placement and times of insertion track adjustments ≥1 were higher(all P＜0.05).Logistic regression analysis showed that,Young-Burgess classification was VS pelvic fracture,fracture line involved zone Ⅱ in Denis classification of sa-cral fractures,common screw placement,times of insertion track adjustments ≥ 1 and low OSTA indexes were risk factors for screw loosening after sacroiliac joint screw internal fixation for posterior pelvic ring injury(all P＜0.001).Conclusion Patients with pelvic VS frac-ture,sacral fracture involving Denis zone Ⅱ,shorter sac-roiliac screw insertion and times of insertion track adjust-ments ≥1 and low OSTA indexes are more prone to screw loosening after sacroiliac joint screw internal fixation for posterior pelvic ring injuries.Clinicians should perform preopera-tive evaluation,optimize surgical techniques and strengthen postoperative management to improve the prognosis of pa-tients with posterior pelvic ring injuries.
Keywords：Pelvic fractureInternal fixationSacroiliac screwScrew looseningLogistic regression analysis
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 466-471 )