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Sacroiliac joint variants are common and gender-specific but do not predict fracture pattern in pelvic ring injuries
Marie Le Baron1, Guillaume David2, Byron A Ward3
1Institute for Locomotion, Department of Orthopedics and Traumatology, Marseille Public University Hospital System, Marseille, France.
Objectives:
To investigate the prevalence of sacroiliac joint (SIJ) anatomical variants in a North American pelvic fracture population and assess associations with fracture patterns and patient demographics.
Methods:
Design Retrospective cohort study.
Setting:
Level I academic trauma center in North America.
Patients/Participants:
270 adult patients who sustained unilateral pelvic ring injury and underwent operative fixation from March 2016 to April 2025.
Intervention:
Postoperative CT scans were used to classify SIJ morphology into eight anatomical variants and assess for sacral dysmorphism.
Main Outcome Measurements:
Prevalence and distribution of SIJ variants, and their correlation with gender, age, and fracture patterns (Young-Burgess and OTA/AO classifications).
Results:
An SIJ variant was present in 74.1% of patients, with semi-circular defect (24.4%) and ilio-sacral complex (21.5%) being the most common. Women more frequently exhibited variant types. Older patients had a higher prevalence of accessory SIJ variants. No significant correlation was found between SIJ anatomy and fracture classification.
Conclusion:
SIJ anatomical variants are highly prevalent in pelvic trauma patients and differ by gender and age. Although these variants did not correlate directly with fracture patterns, they may influence joint biomechanics and should be considered in trauma evaluation and surgical planning.
Level Of Evidence:
level III, retrospective cohort study.
