L5-S1 facet joint pathology in pelvic ring injuries

• Published in: European journal of orthopaedic surgery & traumatology 2024-12, Vol.34 (8), p.4057-4063
• Main Authors: Danford, Nicholas C., Tavolaro, Celeste, Ohlsen, Suzanna, Khilfeh, Bilal, Agel, Julie, Githens, Michael, Kleweno, Conor, Bellabarba, Carlo, Firoozabadi, Reza
• Format: Article
• Language: English
• Subjects: Joint and ligament injuries; Medicine; Medicine & Public Health; Original Article; Orthopedics; Surgical Orthopedics; Traumatic Surgery
• ISSN: 1432-1068; 1633-8065; 1432-1068
• DOI: 10.1007/s00590-024-04107-1

Background The authors believe that the L5-S1 facet joint injury in the setting of pelvic fractures is underappreciated by orthopedic traumatologists. The purpose of this study was to draw attention to the L5/S1 facet joint in the setting of pelvic ring injuries. Methods This was a retrospective comparative study of all patients greater than or equal to 18 years of age with an acute pelvic ring injury (AO/OTA 62 B to C) presenting to a single level I trauma center. The primary objective was to determine demographic and injury characteristics associated with L5-S1 facet joint injuries in patients with pelvic ring injuries. The secondary objective was to determine the proportion of L5-S1 facet joint injuries that were missed on initial radiographic workup. Results There were 476 patients included in the analysis, 53 (11.1%) of whom had an L5-S1 facet joint injury. Patients with an L5-S1 injury were more likely to be younger (44.1 vs. 53.2 years, p  = 0.001) and experience a high energy mechanism of injury (95.0% vs. 78.0%, p  = 0.002). Certain injury patterns were associated with L5-S1 facet joint injuries: any sacral fracture (96.2% vs. 73.8%, p