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Abstract
Purpose
To assess the affecting factors of results after the operation of Crescent fracture-dislocation in sacro-iliac joint.
Materials and Methods
In 19 patients (mean age, 47.4 year-old) of open reduction and internal fixation for Crescent fracture-dislocation, there were seven type I, 9 type II, and 3 type III fractures according to Day's classification. We assessed affecting factors of radiological and functional results, such as patients' ages, surgical approaches, the fixation extent of pelvic ring, and fracture patterns.
Results
Seventeen of 19 cases united at 14.5 weeks in average, and 2 non-unions occurred with the fixation failure of posterior ring. Satisfactory results were 14 and 15 in radiological and functional evaluation, respectively. In complications, three cases of leg length discrepancy were from an imperfect reduction and two fixation failures. Surgical approach did not show any difference of results, but all cases of unsatisfactory reduction occurred from posterior ring fixation through the anterior approach. Fixation of both rings seemed to have satisfactory results, comparing to posterior ring only. Older patients over 60 year-old had more complications and a tendency to show an unsatisfactory result.
Figures and Tables
Fig. 1
Classification of crescent fracture according to Day et al. The positions of the principal fracture lines are shown for crescent fracture-dislocation types I, II and III, as defined by axial CT sections, reformatted parallel to the sacroiliac superior end-plate.
Fig. 2
(Patient 2) (A, B) A 19-year-old woman had a lateral compression injury of the pelvic ring from the right side.
(C) A 3 dimensional CT scan shows the crescent fragment of iliac fracture (arrow).
(D) The axial film shows type I of Day classification.
Fig. 3
(Patient 2) (A, B) Through the anterior approach, anatomical reconstruction was achieved with the fixation of anterior and posterior rings.
(C, D) The fractures were united at 12 weeks.
Fig. 4
(Patient 14) (A, B) A 49-year-old man had a Type II of crescent fracture-dislocation.
(C) The fracture of posterior ring was fixed with three reconstruction-plates through the posterior approach.
(D) After 6 years, he had an excellent function with the union.
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