J Korean Fract Soc.  2014 Apr;27(2):151-156. 10.12671/jkfs.2014.27.2.151.

Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release

• Choi KC
• Ha JY
• Kim WY

• KMID: 1703114
• DOI: http://doi.org/10.12671/jkfs.2014.27.2.151

Abstract

Nonunion of an unstable pelvic fracture with cranial displacement pelvic surgery is technically difficult due to a large amount of bleeding and the risk of nerve damage. In addition, surgical correction of leg length discrepancy by reduction of a dislocated sacroiliac joint is in high demand. Nevertheless, when a patient is strongly disabled by a pelvic deformity, surgical correction may be necessary. Two patients with pelvic deformity were treated successfully by surgical correction and osteosynthesis.

Keyword

Pelvic bones; Leg length unequiality; Ununited fractures

MeSH Terms

Congenital Abnormalities
Fractures, Ununited
Hemorrhage
Humans
Leg
Pelvic Bones
Sacroiliac Joint

Figure

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  Fig. 1 (A) Initial post-accident computed tomography scan showing both a rami fracture and a left sacral wing fracture (Tile type C). (B) Pelvic reduction and stabilization with anterior pelvic external fixator only. (C) Six months after the accident, simple radiographs showing superior migration of the left hemipelvis and nonunion of the fracture site. (D) Simple radiographs after surgical correction showing decreased cranial displacement.

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  Fig. 2 (A) Approximately 3 cm cranial displacement of right hemipelvis. (B) One year after surgical correction, simple radiographs showing anatomical reduction and bony union.

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  Fig. 3 Preoperative magnetic resonance imaging showing L5 nerve root, tracks inferior over the sacral wing.

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  Fig. 4 (A) Postoperative computed tomography (CT) scan showing that the S1 sacroiliac screws lie on a safety zone, angled 10 degrees anteriorly. (B) Postoperative CT scan showing that the S2 sacroiliac screws lie on a safety zone, parallel to the floor.

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