Percutaneous iliosacral screw fixation in vertically unstable pelvic injuries, a refined conventional method

Percutaneous ilio-sacral screw fixation is a well-established method for fixation of unstable posterior pelvic lesions. Due to unavailability of the navigation system in our institute and the limits of using CT-guided method, we tried to refine the conventional method. Between March 2011 and Nov. 2012, twenty patients with closed vertical pelvic injuries were admitted. They were 17 males and three females with an average age of 34 years (range from 27 to 55). Percutaneous ilio-sacral screw fixation was done in the supine position using a Schanz screw marking of a fixed entry point in the outer iliac table. Closed reduction was done in all cases with excellent reduction in 14 cases, good in two and fair in four cases. The mean duration of screw insertion was 17 minutes (ranged from 10 to 25). One case of injury of the superior gluteal vessels was present and one case with misplacement through the ventral part of contra-lateral sacral ala. No neurological complications were detected. Ilio-sacral screw fixation by this refined technique allows safe stabilization of vertical pelvic lesions with an acceptable complication rate.