{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T12:35:50Z","timestamp":1787661350650,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Operative treatment of fragility fractures of the pelvis has become a gold standard. Preoperative planning, including the assessment of the pathway for iliosacral screws, is crucial. The anchorage of the screw depends on the bone quality. Some recent studies have concentrated on assessing bone mineral density (BMD) with the use of Hounsfield unit (HU) values obtained from CT scans. The aim of the present study is to determine the best sacral levels of S1\u2013S3 on the pathway of iliosacral screws for sacroiliac joint fixation. Methods: Patients admitted to the Independent Public Healthcare Center in Rypin between 1 of September and 1 of December in 2023, who had CT scans of the pelvis performed on them for different reasons, were included in this study. In total, 103 patients\u201456 men and 47 women\u2014were enrolled in the study and consecutively separated into two groups of different ages: 18\u201360 years old (group A) and above 60 years old (group B). The volumetric bone density expressed in HU values was measured with sacral levels of S1, S2 and S3. Apart from the bodies of sacral vertebrae S1\u2013S3, our measurements involved the ala of the ilium in the vicinity of the sacroiliac joint and the wing of the sacrum. All the measurements were performed on the pathway of presumptive iliosacral screws to stabilize the sacroiliac joint. Results: In group A (58 patients) the highest bone density in sacral bodies was found in S1 that gradually decreased to S3, while the opposite tendency was demonstrated in the ala of ilium. The HU values in the wing of the sacrum did not display statistical significance. In group B (45 patients), the highest bone density was also found in the sacral body S1 that decreased toward S3 but in the ala of ilium, the highest bone density was found with level S1 and lowest with level S2. In both groups, the highest bone density referred to the wing of the sacrum. Conclusion: While the perfect construct for posterior pelvic ring fixation remains unclear, our findings may imply that sacroiliac joint screws inserted into the wing of the sacrum of greater bone density could provide much more successful fixation in comparison to those anchored in the body of sacral vertebra of lesser bone density.<\/jats:p>","DOI":"10.3390\/jcm13206063","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T08:10:16Z","timestamp":1728634216000},"page":"6063","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["CT-Based Evaluation of Volumetric Posterior Pelvic Bone Density with Implications for the Percutaneous Screw Fixation of the Sacroiliac Joint"],"prefix":"10.3390","volume":"13","author":[{"given":"Micha\u0142","family":"Ku\u0142akowski","sequence":"first","affiliation":[{"name":"Clinical Department of Orthopedics and Traumatology, Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karol","family":"Elster","sequence":"additional","affiliation":[{"name":"Clinical Department of Orthopedics and Traumatology, Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2981-5794","authenticated-orcid":false,"given":"Micha\u0142","family":"Janiak","sequence":"additional","affiliation":[{"name":"Clinical Department of Orthopedics and Traumatology, Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Ku\u0142akowska","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Medical College, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5605-7554","authenticated-orcid":false,"given":"Pawe\u0142","family":"\u017buchowski","sequence":"additional","affiliation":[{"name":"Clinic of Rheumatology and Connective Tissue Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Collegium Medicum in Bydgoszcz, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafa\u0142","family":"Wojciechowski","sequence":"additional","affiliation":[{"name":"Clinic of Rheumatology and Connective Tissue Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Collegium Medicum in Bydgoszcz, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Dura","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Collegium Medicum in Bydgoszcz, 85-168 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Lech","sequence":"additional","affiliation":[{"name":"Clinical Department of Orthopedics, Traumatology and Hand Surgery, Jan Mikulicz-Radecki University Clinical Hospital in Wroclaw, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Korolczuk","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Traumatology and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Grzonkowska","sequence":"additional","affiliation":[{"name":"Department of Normal Anatomy, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University in Toru\u0144, 87-100 Toru\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Szpinda","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Bydgoszcz University of Science and Technology, 85-796 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariusz","family":"Baumgart","sequence":"additional","affiliation":[{"name":"Department of Normal Anatomy, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University in Toru\u0144, 87-100 Toru\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1007\/s00198-021-06152-6","article-title":"Epidemiology and economic burden of fragility fractures in Austria","volume":"33","author":"Muschitz","year":"2022","journal-title":"Osteoporos. 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