Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures

Anatomic Determinants of Sacral Dysmorphism and Implications for Safe Iliosacral Screw Placement

“…Other studies have shown that patients with all of these characteristics have a more narrow and angled osseous corridor in the first sacral segment compared with those who exhibit none of these characteristics 23,28,29 . Using these criteria to adjust operative planning, surgeons can achieve percutaneous fixation of pelvic fractures with low rates of neurovascular injury, ranging from 0% to 1% 2,6 . We studied a large cohort of uninjured pelves to represent the variance in morphology within the general population.…”

“…The sacral dysmorphism score quantifies dysmorphism and can be used in preoperative planning of iliosacral screw placement. P ercutaneous iliosacral screw fixation has been widely adopted as a safe method for treatment of unstable pelvic ring injuries [1][2][3][4][5][6][7] . The use of iliosacral screws is increasing, probably as a result of increased training in the technique, an increase in the incidence of pelvic ring injuries, and increased survival of patients with unstable pelvic ring injuries 8,9 .…”

“…The use of iliosacral screws is increasing, probably as a result of increased training in the technique, an increase in the incidence of pelvic ring injuries, and increased survival of patients with unstable pelvic ring injuries 8,9 . Published series have demonstrated successful outcomes of percutaneous iliosacral screw fixation 5,6,10,11 . These studies have shown high rates of radiographic and clinical success, but also a risk of neurovascular injury [12][13][14][15][16] .…”

A Minimally Invasive Stabilizing System for Dorsal Pelvic Ring Injuries

“…However, some surgical approaches for treatment of unstable posterior pelvic ring injuries have disadvantages: (1) anterior plate fixation of the sacroiliac joint places the L5 root at risk during dissection and implant placement, and tremendous blood loss [2,8]; (2) posterior fixation with transiliac sacral bars that bridge the contralateral sacroiliac joint and cause discomfort in thin patients owing to prominent implants [4]; (3) posterior plate osteosynthesis (open or in a minimally invasive percutaneous technique), intraoperatively, correct bending of the plates is sometimes difficult to achieve and an extended approach for hardware removal might be necessary even in initial percutaneous techniques [19]; and (4) screw fixation of the sacroiliac joint (open or in a percutaneous technique) for which an experienced surgeon and high intraoperative fluoroscopic quality are essential [1,30,34]. One mechanical study suggests there are no differences in secondary fracture displacement among these techniques, and the best treatment remains controversial [42].…”

Health-related quality of life and life satisfaction in patients following surgically treated pelvic ring fractures. A prospective observational study with two years follow-up

“…There are numerous reports in the literature describing radiological and clinical results. [8][9][10]12,17 For instance, it has been shown that an adequate reduction of any posterior displacement is associated with less pain compared with pelvic fractures or disruptions with persistent malreduction of the posterior part, leading to a malunion. 14 To get a better global understanding of the outcome following various injuries and diseases, studies including patient-reported outcome have in recent years provided new and valuable insights.…”