Anterior approach to the sacroiliac joint for pelvic ring fractures: Technical note

Displaced pelvic fractures, combining an anterior lesion and sacroiliac disruption, most often require multiple surgical approaches. The technique we describe here allows these lesions to be treated by a single approach. It combines a Stoppa approach to address the anterior lesion and a pararectus approach to the sacroiliac joint through the same incision under the rectus abdominis muscle. This pararectus approach is done by passing laterally to the external and common iliac vessels. The entire anterior surface of the sacroiliac joint is exposed by the same passage through the abdominal wall. No neurological or vascular complications occurred in a 7-patient case series. Reduction was achieved in all cases. This approach is an interesting alternative to traditional approaches and enriches the surgeon's therapeutic arsenal for managing these complex fractures.