Long-term outcome of sacroiliac disruptions in children

We retrospectively evaluated the outcome of sacroiliac-joint disruption in 18 children, ranging in age from 2 to 16 years. Ten patients were treated with bedrest; eight were treated surgically. Follow-up was performed at an average of 14 years (range, 8-23); three patients had daily back pain, and six had occasional back pain. Six patients had limited lumbosacral motion, but only two were symptomatic. The sacroiliac joint was fused in nine patients and irregular in four. Fracture reduction had been incomplete in nine patients, of whom five had a vertical shear injury. All developed complete or incomplete fusion of the sacroiliac joint, but we could not find a clear relationship between the often impressive radiographic changes and symptoms. Nine patients had a leg-length discrepancy of > 1 cm; three patients had pelvic asymmetry. Disabling long-term symptoms persisted from incomplete neurologic recovery in six patients.