ArticleOrthopaedic surgery2023
Incidence of and Risk Factors for Screw Loosening after Iliosacral Screw Fixation for Posterior Pelvic Ring Injury.
Article in Orthopaedic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Is anterior pelvic ring fixation associated with lower incidence of posterior hardware failure in elderly patients with pelvic ring injuries?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Enhanced fixation in sacral fragility fractures: the role of the transsacral bar in preventing screw loosening.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Percutaneous fixation of posterior pelvic ring lesions in the elderly: current evidence and recent advances.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Review
- Removal, Refixation, and Augmentation of a Broken Iliosacral Screw: A Percutaneous Surgical Technique.Case reports in orthopedics · 2026Article
- Surgical management and outcomes of pure sacroiliac joint dislocations: A systematic review.Journal of orthopaedics · 2025Review
- Porous threaded titanium implant screws have higher insertional torque compared to standard screws.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Freehand Placement of a Transiliac-Transsacral Screw for Fixation of Posterior Pelvic Ring Injuries.Orthopaedic surgery · 2025Article
- Age and fixation strategy as associated factors for sacroiliac joint dysfunction after posterior pelvic ring fixation.Frontiers in surgery · 2025Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
purposesScrew loosening is a common complication of iliosacral screw fixation, with subsequent loss of stability and fracture re-displacement. This study aimed to investigate the incidence of and risk factors for screw loosening after iliosacral screw fixation for posterior pelvic ring injury.
methodsA total of 135 patients with posterior pelvic ring injuries who were treated with iliosacral screw fixation in our department between July 2015 and April 2021 were selected for this retrospective analysis. The possible risk factors for screw loosening were investigated using univariate and multivariate logistic regression analyses of patient demographics and trauma-related and iatrogenic variables, including age, sex, body mass index, Osteoporosis Self-Assessment Tool for Asians (OSTA) index, mechanism of injury, Young-Burgess classification, site of injury, type of injury, type of screw, mode of fixation, numbers of guidewire adjustments, accuracy of screw position, and quality of fracture reduction.
resultsThe incidence of screw loosening was 15.6% (n = 21). The mean duration for screw loosening was 3.2 ± 1.5 months after operation. Univariate analysis results showed that the Young-Burgess classification, type of injury, site of injury, type of screw, mode of fixation, and OSTA index might be related to screw loosening (p < 0.05). According to the multivariate logistic regression, vertical shear injuries (Odds ratios [OR] 9.80, 95% Confidence intervals [CI] [1.96-73.28], p = 0.008), type of injury (OR 0.25, 95% CI [0.13-0.79], p = 0.027), common screws (OR 6.94, 95% CI [1.53-31.40], p = 0.012), screws insertion only at the level of the first sacral segment (S1) (OR 8.79, 95% CI [1.18-65.46], p = 0.034), injury site located in the medial sacral foramina (OR 6.28, 95% CI [1.16-34.06], p = 0.033), and lower OSTA index [OR 0.41, 95% CI [0.24-0.71], p = 0.001] were significantly related to screw loosening.
conclusionsVertical shear injuries, sacral fractures, injury site located in the medial sacral foramina, and lower OSTA index are significantly associated with the postoperative occurrence of screw loosening. Transiliac-transsacral screw fixation and screws insertion both at the level of the S1 and second sacral segment can prevent screw loosening.
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