Yonsei Med J.  2012 Mar;53(2):422-426. 10.3349/ymj.2012.53.2.422.

Anterior Pelvic Plating and Sacroiliac Joint Fixation in Unstable Pelvic Ring Injuries

• Choy WS
• Kim KJ
• Lee SK
• Park HJ

• KMID: 1120212
• DOI: http://doi.org/10.3349/ymj.2012.53.2.422

Abstract

PURPOSE
To analyze the effectiveness of anterior pelvic plating and subsequent percutaneous sacroiliac joint screw fixation in patients with unstable pelvic ring injuries.
MATERIALS AND METHODS
Thirty-two patients were included with twenty-one males and eleven females. The mean age was 41 years (range, 19-76). The mean follow-up period was 51 months (range, 36-73). According to AO-OTA classification, there were 11 cases of B2 injuries, 8 cases of B3 injuries, 9 cases of C1 injuries, 2 cases of C2 injuries and 2 cases of C3 injuries. In the posterior lesions, there were 20 cases of sacral fractures and 12 cases of sacroiliac joint disruptions or dislocations. Anterior pelvic plating and subsequent percutaneous sacroiliac joint fixation were performed.
RESULTS
The clinical results were 16 cases of excellent, 10 cases of good, 4 cases of moderate and 2 cases of poor functional results. The 2 cases out of 7 moderate reductions had poor functional results with residual neurologic symptoms. The radiological results were 16 cases of anatomic, 9 cases of nearly anatomic and 7 cases of moderate reduction. All patients were healed except 3 cases of nonunion at the pubic ramus. The complications encountered were 3 cases of screw loosening, 2 cases of anterior plate breakage and 1 case of postoperative infection.
CONCLUSION
In patients with unstable pelvic ring injuries, anterior pelvic plating and subsequent percutaneous sacroiliac joint screw fixation may be a useful surgical option. The radiological results and residual neurologic symptoms had effects on its functional results.

Keyword

Pelvic ring injuries; anterior pelvic plating; sacroiliac joint fixation

MeSH Terms

Adult
Aged
Female
Fracture Fixation, Internal/*methods
Humans
Male
Middle Aged
Pelvic Bones/*injuries/*surgery
Sacroiliac Joint/*injuries/*surgery
Treatment Outcome
Young Adult

Figure

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  Fig. 1 (A and B) Plain radiograph and 3-D reconstructive CT scan of pelvis show bilateral ramus fractures, left-sided sacral fracture (type I) and right-sided iliac fracture. (C) Immediate postoperative X-ray shows anterior pelvic plating and sacroiliac joint screw fixation. Anatomical reduction is obtained. (D) Final radiograph shows well-maintained and complete union with excellent clinical result. CT, computed tomography.

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