Posterior pelvic ring fractures: closed reduction and percutaneous CT-guided sacroiliac screw fixation

Cardiovasc Intervent Radiol. 1997 Jul-Aug;20(4):285-94. doi: 10.1007/s002709900153.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Screws*
  • Female
  • Fracture Fixation, Internal*
  • Fractures, Bone / diagnostic imaging
  • Humans
  • Ilium / diagnostic imaging
  • Ilium / injuries*
  • Male
  • Middle Aged
  • Punctures
  • Radiography, Interventional*
  • Sacrum / diagnostic imaging
  • Sacrum / injuries*
  • Tomography, X-Ray Computed*