Objective: To report the clinical experience in trans-sacroiliac joint with plate via the anterior approach in management of posterior pelvic injuries.
Methods: The clinical data of 29 cases (30 sides) with pelvic injury, 16 being of type B, and 13 of type C according to the Tile classification; with the average displacement of the posterior ring injuries of 18 mm; undergoing trans-sacroiliac joint with plate via the anterior approach from January 2002 to June 2007 were analyzed retrospectively, among which 20 sides were fixed by two plates across the sacroiliac joint and 10 sides by single plate. The anterior pelvic injuries of 22 cases were fixed by plates too. Twenty-one cases were followed up for 35 months on average.
Results: The average operation time was 3 hours, and the average blood transfusion was 1200 ml. Reduction was excellent in 23 sides (77%), good in 6 sides (20%), and fair in 1 side (3%). Operative injury of lumbosacral trunk occurred in 3 sides (10%) and operative injury of lateral femoral cutaneous nerve occurred in 7 sides (23%). Intra-operative major hemorrhage occurred in 2 cases. The average outcome score according to the Majeed grading system was 93, and the function results all were excellent or good.
Conclusion: Plating the sacroiliac joint through the anterior approach is an effective method for the management of sacroiliac dislocation or trans-iliac fracture dislocation, while the blood loss of the operation is obvious, and the risk of iatrogenic nerve injury is high.