Reduction and fixation of sacroiliac joint dislocation by the combined useof S1 pedicle screws and the Galveston technique

Study Design. This retrospective study was designed to analyze the results of the treatment with S1 pedicle screws and the Galveston technique of seve n patients with sacroiliac dislocation. Objectives. To evaluate the effectiveness of the combined use of S1 pedicle screws and the Galveston technique for the treatment of sacroiliac disloca tion. Summary of Background Data. Although several procedures for internal fixati on of sacroiliac dislocation have been reported, there have been no reports discussing surgical treatment of sacroiliac dislocation by the combined us e of S1 pedicle screws and the Galveston technique. Methods. Seven patients with sacroiliac dislocation were treated with pedic le screws of S1 and iliac rod according to the Galveston technique. In the seven patients, the dislocation was associated with vertical displacement o f the sacroiliac joint and rotational deformity of the pelvic ring. They we re classified into Type-C pelvic disruption according to the Tile's classif ication. Three patients with disruption of the symphysis pubis underwent ad ditional fixation of the symphysis using a dynamic compression plate. The r emaining four patients were treated by the posterior procedure alone. Results. The vertical displacement was completely reduced in five patients, and the rotational deformity was completely corrected in four patients. Th e reduction was maintained at the time of the final follow-up evaluation. T here were no perioperative complications with the exception of late infecti on in one patient. Conclusions. The combined use of S1 pedicle screws and the Galveston techni que provided immediate stability and sufficient reduction for sacroiliac di slocation in seven patients in this study. This hybrid internal fixation pr ocedure is useful for reduction and fixation of sacroiliac dislocation asso ciated with the vertical and rotational instability of the pelvic ring.