Anterior pelvic plating and sacroiliac joint fixation in unstable pelvic ring injuries.
OBJECTIVE
To analyze the effectiveness of anterior pelvic plating and subsequent percutaneous sacroiliac joint screw fixation in patients with unstable pelvic ring injuries.


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.


CONCLUSIONS
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.
Department of Orthopaedic Surgery, Eulji University College of Medicine, 1306 Dunsan-2 dong, Seo-gu, Daejeon 302-799, Korea.
Won-Sik
WS
Choy
Kap Jung
KJ
Kim
Sang Ki
SK
Lee
Hyun Jong
HJ
Park
D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery*; D012446:Sacroiliac Joint / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult