J Korean Orthop Assoc.  2012 Oct;47(5):375-381. 10.4055/jkoa.2012.47.5.375.

Pediculo-Iliac Screw Fixation in Vertically Unstable Posterior Pelvic Ring Injury

Affiliations
  • 1Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea. w00wa@dmc.or.kr

Abstract

Herein, we report 5 cases of vertically unstable posterior pelvic ring injuries treated by pediculoiliac fixation. We enrolled 5 patients (male 3, female 2) with vertically unstable posterior pelvic ring injuries treated by pediculo-iliac fixation. Prior to and following the surgery, radiologic results were compared using Matta and Saucedo's method and the clinical results before and after surgery were compared using the Postel score. The outcomes of radiological evaluation were anatomic reduction in 3 cases and nearly anatomic in 1. The mean postel score at last follow up was very good in 4 cases and poor in 1 case. Lumbosacral pediculo-iliac screw fixation enables early ambulation and it is considered a useful method.

Keyword

pelvic ring injury; pediculo-iliac fixation

MeSH Terms

Early Ambulation
Female
Follow-Up Studies
Humans

Figure

  • Figure 1 A 21-year-old female patient who was injured by traffic accident. (A) The initial pelvis antero-posterior radiograph and (B) computed tomography show right SI joint separation, right iliac crescent fracture, right sacral ala fracture and both. superior and inferior ramus fracture. (C) Anterior external fixation and posterior pedicullo-iliac fixation were done. (D) At postoperative 1 year, pelvis radiograph shows no further displacement and implant breakage.

  • Figure 2 A 29-year-old male patient who was injured by traffic accident, he had a left sacrum fracture (Denis classification II) and symphysis pubis separation. (A) At pelvis antero-posterior radiograph, there were sacrum fracture, symphysis pubis separation and left superior and inferior pubic ramus fracture. (B) Computed tomography shows vertically unstable transforaminal sacrum fracture. (C) Anterior external fixation and posterior pedicullo-iliac fixation were done. (D) At postoperative 2 months, pelvis radiograph shows symphysis pubis re-separation and sacral screw cap breakage.


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