Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures.

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.