Fixation of posterior pelvic disruption by trans-iliac bar using ISOLA rods and hooks

Abstract

Surgical stabilization of posterior pelvic disruption (sacral fractures — Denis types II—III) is still a challenge for spine and trauma surgeons alike. Several methods of fixation were described (traction, external fixation and internal fixation). Sacral bars, inserted after open reduction, are a recognized method for fixation of sacroiliac joint disruption and/or sacral fractures with or without anterior pelvic ring disruption. A modification of sacral bar with Harrington instrumentation had been used since 1974. We present the case of a 26 years old healthy female with a dislocated grade II sacral fracture, with contra-lateral fractures of both pubic rami. She underwent open reduction and internal fixation with two ISOLA rods and hooks. At one-year follow-up, good result, with fracture union, and no neurovascular complications, was achieved. We suggest the use of ISOLA rods and hooks as an alternative method to fix posterior pelvic disruption (Denis types II—III).