To analyze the clinical and radiological results of open reduction and plate fixation through the anterior approach for sacroiliac joint separation in unstable pelvic fracture.

We retrospectively reviewed fifteen cases treated by open reduction and plate fixation through the anterior approach from January 1994 to July 2000. Cases were followed up for more than one year, and the radiological results were evaluated according to the largest displacement and leg length discrepancy. The clinical results were evaluated according to pain and functional disabilities.

Ten patients had mild pain not requiring analgesics, and one patient had a slight limp. The average sacroiliac joint separation improved from a mean preoperative value of 13.5 mm (range, 10-23 mm) to a mean postoperative value of 4.8 mm (range, 3-6 mm). Leg length discrepancy, which averaged 11 mm (range, 3-28 mm) preoperatively, decreased to 3.5 mm (range, 0-6 mm) postoperatively. All patients attained anatomical reduction postoperatively and no patient experienced loss of fixation during the follow up period.

Open reduction and plate fixation for unstable pelvic fracture through the anterior approach is a useful method, as evidenced by the satisfactory clinical and radiological results.