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Fixation of posterior pelvic ring disruptions through a posterior approach

  • New Technique
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Orthopedics and Traumatology

Abstract

Objective

Stable internal screw fixation of posterior pelvic ring disruptions through a posterior approach.

Indications

Complete, unstable sacroiliac dislocations with incompetence of anterior and posterior sacroiliac ligaments.

Sacroiliac fracture dislocations.

Displaced vertical sacral fractures.

Contraindications

Damage to posterior soft tissues.

Acceptable closed reduction of sacrum or sacroiliac joint.

Ipsilateral acetabular fractures treated through an anterior approach.

Inadequate intraoperative fluoroscopic visualization of posterior pelvis.

Surgical Technique

Vertical paramedian incision overlying the sacroiliac joint.

Release of origin of gluteus maximus. Inspection and reduction of sacroiliac joint. Stabilization with iliosacral screws under image intensification. Secure repair of gluteal fascia.

Results

107 patients with unstable pelvic ring fractures were treated with open reduction and internal fixation of which 83 had an open reduction of posterior ring injuries. Accuracy of reduction: more than 95% of patients had residual displacement of less than 10 mm. Two patients had a deep wound infection postoperatively. Two-thirds of the patients were able to resume their previous occupation. Pain was either absent or occurred only with strenuous activities. 63% had a normal gait.

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Authors and Affiliations

  1. Boston University Medical School, 850 Harrison Avenue, 02118, Boston, MA, USA

    Paul Tornetta MD (Associate Professor)

Authors
  1. Bruce French
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  2. Paul Tornetta MD
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Corresponding author

Correspondence to Paul Tornetta MD.

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French, B., Tornetta, P. Fixation of posterior pelvic ring disruptions through a posterior approach. Orthop Traumatol 10, 27–46 (2002). https://doi.org/10.1007/s00065-002-1035-y

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  • DOI: https://doi.org/10.1007/s00065-002-1035-y

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