Related Experiment Videos
Posterior pelvic ring fractures: closed reduction and percutaneous CT-guided sacroiliac screw fixation
A L Jacob1, P Messmer, K W Stock
1Institute of Diagnostic Radiology, Kantonsspital-Universitätskliniken, CH-4031 Basel, Switzerland.
Purpose:
To assess the midterm results of closed reduction and percutaneous fixation (CRPF) with computed tomography (CT)-guided sacroiliac screw fixation in longitudinal posterior pelvic ring fractures. To document radiographic and CT follow-up patterns.
Methods:
Thirteen patients with 15 fractures were treated. Eleven patients received a unilateral, two a bilateral, screw fixation. Twenty-seven screws were implanted. Continuous on-table traction was used in six cases. Mean radiological follow-up was 13 months.
Results:
Twenty-five (93%) screws were placed correctly. There was no impingement of screws on neurovascular structures. Union occurred in 12 (80%), delayed union in 2 (13%), and nonunion in 1 of 15 (7%) fractures. There was one screw breakage and two axial dislocations.
Conclusion:
Sacroiliac CRPF of longitudinal fractures of the posterior pelvic ring is technically simple, minimally invasive, well localized, and stable. It should be done by an interventional/surgical team. CT is an excellent guiding modality. Closed reduction may be a problem and succeeds best when performed as early as possible.