Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures

Summary Objective To report clinical results of patients treated with closed reduction and percutaneous iliosacral screw fixation for unstable pelvic ring fractures. Materials and methods Retrospective study using medical records, images and late clinical assessment of all patients treated in our centre with percutaneous iliosacral screw fixation for unstable pelvic ring fractures, with a minimum follow-up of 12 months. Seventy-three patients with a mean age of 40.3 years old (range 14–70 years) were treated between July 1998 and December 2005. Seventy-one patients were included. Fractures types included 10 AO type B and 61 AO type C injuries. Forty-two patients had associated injuries. Mean follow-up was 31 months (12–96). Functional status was assessed using Majeed's grading score for pelvic fractures at final follow-up. Results Sixty-nine patients obtained a satisfactory initial reduction. Two patients had transitory postoperative neurological deficit. Five patients presented hardware failure. Fifteen patients developed sacroiliac osteoarthritis during follow-up. Good and excellent functional results were observed in 66 patients at final follow-up. Five patients had bad results, one due to infection of an anterior pelvic plate and the others due to painful refractory sacroiliac osteoarthritis that required a sacroiliac fusion. Sixty-one (86%) patients were able to return to pre-injury occupation. Conclusions Good clinical results with a low and predictable rate of complications can be expected using closed reduction and percutaneous iliosacral screw fixation for unstable pelvic ring fractures.