Minimally invasive stabilisation of posterior pelvic-ring instabilities with a transiliac locked compression plate

Int Orthop. 2012 Jan;36(1):159-64. doi: 10.1007/s00264-011-1279-6. Epub 2011 May 31.

Abstract

Purpose: Sacroiliac screw fixation is the method of choice for the definitive treatment of unstable posterior pelvic-ring injuries; however, this technique is demanding and associated with a high risk of iatrogenic neurovascular damage. This study evaluates whether minimally invasive transiliac locked compression plate stabilisation may be an alternative to sacroiliac screw fixation in unstable posterior pelvic-ring injuries.

Methods: We performed a retrospective analysis of patients with unstable pelvic-ring injuries treated with a transiliac locked compression plate at a level I trauma centre. Outcome evaluation was assessed using the Pelvic Outcome Score and analysis of complications, intraoperative fluoroscopic time, and duration of the surgical procedure.

Results: Twenty-one patients were available for follow-up after an average of 30 months. The main findings were as follows: Overall outcome for the Pelvic Outcome Score was excellent in 47.6% (ten patients), good in 19% (four patients), fair in 28.6% (six patients), and poor in 4.8% (one patient). Average operation time was 101 min and intraoperative fluoroscopic time averaged 74.2 s. No iatrogenic neurovascular injuries were observed.

Conclusion: Minimally invasive transiliac locked compression plate stabilisation may be a good alternative to sacral screw fixation because it is quick, safe and associated with a good functional outcome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Plates*
  • Bone Screws / adverse effects
  • Female
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods*
  • Fractures, Bone / surgery*
  • Humans
  • Joint Instability / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Pelvic Bones / injuries*
  • Postoperative Complications
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult