Background and Objectives: The number of geriatric patients presenting with fragility
fractures of the pelvis is increasing due to ageing Western societies. There are nonoperative and
several operative treatment approaches. Many of which cause prolonged hospitalisation, so patients
become bedridden and lose mobility and independence. This retrospective study evaluates the
postoperative outcome of a computed tomography-guided (CT-guided) minimally invasive approach
of sacroiliac screw osteosynthesis. The particular focus is to demonstrate its ease of use, feasibility
with the equipment of virtually every hospital and beneficial outcomes to the patients. Materials and
Methods: 28 patients (3 men, 25 women, age 80.5 ± 6.54 years) with fragility fractures of the pelvis
types II-IV presenting between August 2015 and September 2021 were retrospectively reviewed. The
operation was performed using the CT of the radiology department for intraoperative visualization
of screw placement. Patients only received screw osteosynthesis of the posterior pelvic ring and
cannulated screws underwent cement augmentation. Outcomes measured included demographic
data, fracture type, postoperative parameters and complications encountered. The quality of life
(QoL) was assessed using the German version of the EQ-5D-3L. Results: The average operation
time was 32.4 ± 9.6 min for the unilateral and 50.7 ± 17.4 for the bilateral procedure. There was no
significant difference between surgeons operating (p = 0.12). The postoperative CT scans were used
to evaluate the outcome and showed only one case of penetration (by 1 mm) of the ventral cortex,
which did not require operative revision. No case of major complication was reported. Following
surgery, patients were discharged after a median of 4 days (Interquartile range 3–7.5). 53.4% of the
patients were discharged home or to rehabilitation. The average score on the visual analogue scale of
the EQ-5D-3L evaluating the overall wellbeing was 55.6 (Interquartile range (IQR) 0–60). Conclusions:
This study shows that the operative method is safe to use in daily practice, is readily available
and causes few complications. It permits immediate postoperative mobilization and adequate pain
control. Independence and good quality of life are preserved