Evaluation of Outcome of Surgical Reduction and fixation of Sacroiliac Crescent Fracture Dislocation.

Abstract

Background: Crescent fractures Sacroiliac result in a rotationally unstable hemipelvis with many complications, they are characterized by the disruption of the sacroiliac joint and extend proximally as a fracture of the posterior iliac wing. Operative intervention is recommended for the anatomical reduction and stable fixation of a crescent fracture-dislocation to restore the normal anatomy.Aim of the work: assessing the outcome of the surgical reduction and fixation of different types of crescent fracture with follow up for one year. Patients and Methods: Our prospective study was conducted involving 24 cases with crescent pelvic fracture. All patients were operated at Zagazig University Hospitals. All cases were surgically managed by reduction of the fractures and internal fixation either by reconstruction plates, iliosacral screws or LC-II screws. Posterior internal fixation alone was used in 13 cases, and a combination of anterior and posterior fixation was done in 11 cases Results: Our results revealed radiologically 21 patients were excellent, 3 were good according to Matta score. 2 patients complained of pain post-operatively, the same 2 patients had moderate ambulation problems. The postoperative infections were present in 2 cases. The mean Majeed score 1 year post-operatively was 90.7/100 for the 15 working patients, and 68/80 for the 11 non-working patients.Conclusion: the best method of fixation is changed according the fracture type, Majeed score and radiological outcome is not related to neither Day’s type of fracture nor method of fixation.