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

Young-Sang Lee; Woo-Sung Kim; Tae-Hoon Park

doi:10.4055/jkoa.2012.47.5.375

Journal List > J Korean Orthop Assoc > v.47(5) > 1013179

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Lee, Kim, and Park: Pediculo-Iliac Screw Fixation in Vertically Unstable Posterior Pelvic Ring Injury

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(5): 375-381.

Published online: 30 October 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.5.375

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

Young-Sang Lee, M.D., Woo-Sung Kim, M.D., Tae-Hoon Park, M.D.

Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea.

Correspondence to: Woo-Sung Kim, M.D. Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, 20, Seohyeon-ro 180beon-gil, Bundang-gu, Seongnam 463-774, Korea. TEL: +82-31-779-0175, FAX: +82-31-779-0176, w00wa@dmc.or.kr

Received 13 December 2011 Revised 10 April 2012 Accepted 16 August 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: pelvic ring injury, pediculo-iliac fixation

Figures and Tables

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.

Table 1

Patient Data of Unstable Posterior Pelvic Ring Injury

M, male; F, female; LC, Lateral compression; CM, combined mechanism; APC, anterior posterior compression; PIS, pediculo-iliac screw fixation; ISS, ilio-sacral screw fixation; EF, external fixator.

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