Abstract
BackgroundCrescent fracture-dislocation of sacroiliac joint is a type of lateral compression pelvic injury associated with instability. These fractures comprise 12% of lateral compression fractures.ObjectiveThe objective of this study is to share the experience and to assess the functional outcome of fixation in crescent fracture-dislocation.MethodsWe analyzed a descriptive case series with clinical data of 15 patients at the Department of Orthopedics Surgery at the Dr. Ruth K.M. Pfau Civil Hospital at Dow University of Health Sciences in Karachi, Pakistan, from January 2016 to August 2018. The patients were treated by closed and open fracture reduction and fixed with percutaneous screws and reconstruction plates.ResultsA total of 15 patients were included in this study with age ranging from 20 to 60 years (11 men [73%]; four women [27%]). According to the mechanism of injury, five (33%) had motorcycle accidents; four (27%) had collision while sitting in a car; three (20%) were pedestrians hit by a vehicle; four (27%) were injured while sitting in van; two (13%) had bus-related injury, and one (6.5%) presented with a history of wall collapse.Five (33%) patients had type I fractures, seven (47%) had type II fractures, and three (20%) had type III fractures Associated injuries were midshaft femur fracture in two patients, contralateral superior and inferior rami fracture in three patients, and open tibia fracture in one patient. All fractures were fixed with reconstruction plates and screws. Patients were kept as non-weight-bearing on the injured joint for three weeks, mobilized non-weight-bearing on the contralateral leg after three weeks, and partial weight-bearing was started at eight weeks; full weight-bearing was started after three months. Nine patients (60%) had excellent outcomes, three (20%) had a good outcome, and three (20%) had a poor outcome.ConclusionCrescent fracture-dislocations are unstable injuries. These fractures should have proper reduction and fixation that will reduce pain, malunion, and shortening.
Highlights
The pelvis is a ring-like structure that bridges the axial skeleton and the lower extremities
All fractures were fixed with reconstruction plates and screws
Crescent fracture-dislocation is a type of pelvic fracture that occurs as a result of lateral compression force
Summary
The pelvis is a ring-like structure that bridges the axial skeleton and the lower extremities. Pelvic fractures are rare injuries which occur at a frequency of approximately 20 to 37 per 100,000 people. Pelvic ring injury is present in 20% of cases [1]. Crescent fracture-dislocation is a type of pelvic fracture that occurs as a result of lateral compression force. Because of the muscular pelvic floor and the sacrospinous and sacrotuberous ligamentous remain intact, the hemipelvis is stable to vertical forces [5,6,7]. Crescent fracture-dislocation of sacroiliac joint is a type of lateral compression pelvic injury associated with instability. These fractures comprise 12% of lateral compression fractures
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