Anterior stabilization of sacroiliac disruption through transiliac osteotomy

Abstract

Background Sacroiliac joint diastases from high-energy trauma are always complicated by pain and disability. Open reduction and anterior stabilization with a plate are biomechanically advanced because of direct reduction and stabilization. We report our experience of managing 15 patients with sacroiliac disruption by anterior double plates. The purpose of this study was to evaluate the effectiveness of anterior pelvic plating for these complicated fractures. Patients and methods This study included 15 patients who sustained sacroiliac disruption from January 2008 to March 2012 at Menoufia University Hospital. All patients were treated by anterior double plates through an anterolateral approach with transiliac osteotomy. All patients were males. Results The average age was 34 years with a range of 20–49 years. The mean follow-up period was 20 months with a range of 12–36 months. The average healing period was 16 weeks. The clinical results according to the Coles pelvic score revealed 12 cases of satisfactory (five of excellent and seven of good) and three cases of unsatisfactory results (two fair and one poor). Conclusion Posterior injuries, especially sacroiliac disruptions, affect the long-term outcome significantly; therefore, an anterior approach would allow adequate exploration and the reduction can be confirmed. Double plates allow rigid fixation. Bone-to-bone healing of osteotomy revealed decreased risk of wound complications.