ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicSurgical Advances in Orthopedic Trauma: A Biomechanical ApproachView all 19 articles
Age and Fixation Strategy as Associated Factors for Sacroiliac Joint Dysfunction After Posterior Pelvic Ring Fixation
Provisionally accepted
- Antalya Eğitim ve Araştırma Hastanesi, Antalya, Türkiye
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Abstract Background: Sacroiliac joint dysfunction (SIJD) is an underrecognized source of postoperative pain and disability after pelvic ring stabilization. Although percutaneous sacroiliac screw fixation provides stable fixation with low morbidity, it restricts physiological SI joint micromotion, potentially causing iatrogenic dysfunction. The relative contributions of injury severity versus fixation strategy to SIJD remain poorly defined. Objectives: To investigate the incidence and factors associated with SIJD after sacroiliac screw fixation for posterior pelvic ring injuries, focusing on fixation laterality (unilateral vs. bilateral) and patient characteristics. Secondary aims included evaluating the functional impact of SIJD on long-term outcomes. Methods: This single-center retrospective cohort study with prospective follow-up included 80 patients (mean follow-up: 42.3 ± 27.3 months; median 36 months [IQR: 16–56]) who underwent sacroiliac screw fixation between 2016 and 2024. Fracture morphology was classified using Tile and Young–Burgess systems. SIJD was diagnosed prospectively based on ≥3 positive provocation tests. Functional outcomes were assessed using the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), and Lower Extremity Functional Scale (LEFS). Statistical analyses included chi-square, Mann–Whitney U, Cohen's κ, effect sizes (Cohen's d), and multivariate logistic regression. Results: SIJD occurred in 20 patients (25%), exclusively after unilateral fixation, whereas none followed bilateral fixation (p = 0.004). SIJD-positive patients were younger (32.1 ± 9.0 vs.
Keywords: Sacroiliac joint dysfunction, Pelvic ring injury, Sacroiliac screw fixation, Unilateral fixation, bilateral fixation, functional outcomes
Received: 06 Oct 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Aktan, Aktan, Ergün, Yüksel and Erol. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cemil Aktan
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