Surgical Fixation of Sacroiliac Joint Complex in Unstable Pelvic Ring Injuries

Kwang-Jun Oh; Seok-Min Hwang

doi:10.5371/hp.2012.24.2.139

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Oh and Hwang: Surgical Fixation of Sacroiliac Joint Complex in Unstable Pelvic Ring Injuries

Original Article

Hip & Pelvis

Hip & Pelvis 2012; 24(2): 139-147.

Published online: 30 June 2012

DOI: https://doi.org/10.5371/hp.2012.24.2.139

Surgical Fixation of Sacroiliac Joint Complex in Unstable Pelvic Ring Injuries

Kwang-Jun Oh, MD, Seok-Min Hwang, MD

Department of Orthopedic Surgery, Konkuk University Medical Center, Seoul, Korea.

Address reprint request to Seok-Min Hwang, MD. Department of Orthopedic Surgery, Konkuk University Medical Center, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea. TEL: +82-2-2030-7615, FAX: +82-2-2030-7369, damioh@gmail.com

Received 19 October 2011 Revised 24 May 2012 Accepted 29 May 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

Purpose

To evaluate the effectiveness and clinical outcomes of surgical fixation of a sacroiliac joint complex in unstable pelvic ring injuries.

Materials and Methods

We selected sixteen cases in our hospital from 2006 to 2010 that underwent surgical fixation of the sacroiliac joint complex and had unstable pelvis ring injuries corresponding to B and C of Tile classification. Plate fixation through an intra-pelvic anterior approach was performed for 9 cases, tension band plate fixation for 2 cases, iliosacral screw fixation for 4 cases, and spino-pelvic fixation through extra-pelvic posterior approach for 1 case. Radiological and clinical evaluations were implemented to determine the results of treatment.

Results

Bone union was observed in all patients. For radiological evaluation using the Matta and Saucedo criteria, 15 cases were above the nearly-anatomic reduction. Out of 10 cases that performed rotational displacement analysis, 9 cases were above fair. All cases had above moderate clinical results as well.

Conclusion

For unstable pelvic ring injuries, the satisfactory radiological and clinical results have been obtained through the anatomical reduction of the sacroiliac joint complex and firm internal fixation. And from the evaluation of fracture types, the Type C fracture and vertical shear type fractures showed relatively poor results.

Keywords: Sacroiliac joint complex, Unstable pelvic ring injury, Surgical outcome

Figures and Tables

Fig. 1

(A) Radiograph shows intra-pelvic anterior approach & plate fixation. (B) Radiograph shows extra-pelvic posterior approach & tension band plate fixation. (C) Radiograph shows extra-pelvic posterior approach & iliosacral screw fixation. (D) Radiograph shows extra-pelvic posterior approach & spino-pelvic fixation.

Fig. 2

(A) CT shows Pre & postoperative rotational displacement.

Table 1

Summary of cases.

(^*LC: Lateral compression, ^†APC: Antero-posterior compression, ^‡VS: Vertical shear)

Table 2

Radiological Result: Fracture Reduction

Table 3

Radiological Result: Rotational Displacement

Table 4

Clinical Result

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