High-Energy Pelvic Ring Disruptions with Complete Posterior Instability: Contemporary Reduction and Fixation Strategies.

Abstract

* Accurate reduction and rigid internal fixation of anterior pelvic ring injuries enhances overall stability of the pelvic ring and augments posterior fixation constructs.* Closed reduction techniques can be highly effective for unstable pelvic ring disruptions and are preferable over open reduction methods.* Percutaneous iliosacral screw fixation is a generally safe and effective method of fixation of posterior pelvic ring injuries.* Multiple and longer (transiliac-transsacral) screws at both sacral segments are required to create a stronger screw construct for complete posterior pelvic disruptions.* Lumbopelvic fixation substantially augments iliosacral screw fixation and is particularly useful for comminuted transforaminal sacral fractures with associated vertical instability.