POSTERIOR PELVIC RING FRACTURES - CLOSED REDUCTION AND PERCUTANEOUS CT-GUIDED SACROILIAC SCREW FIXATION

Purpose: To assess the midterm results of closed reduction and percuta neous fixation (CRPF) with computed tomography (CT)-guided sacroiliac screw fixation in longitudinal posterior pelvic ring fractures. To doc ument radiographic and CT follow-up patterns. Methods: Thirteen patien ts with 15 fractures were treated. Eleven patients received a unilater al, two a bilateral, screw fixation. Twenty-seven screws were implante d. Continuous on-table traction was used in six cases. Mean radiologic al follow-up was 13 months. Results: Twenty-five (93%) screws were pla ced correctly. There was no impingement of screws on neurovascular str uctures. Union occurred in 12 (80%), delayed union in 2 (13%), and non union in 1 of 15 (7%) fractures. There was one screw breakage and two axial dislocations. Conclusion: Sacroiliac CRPF of longitudinal fractu res of the posterior pelvic ring is technically simple, minimally inva sive, well localized, and stable. It should be done by an intervention al/surgical team. CT is an excellent guiding modality. Closed reductio n may be a problem and succeeds best when performed as early as possib le.