Posterior pelvic ring injuries: classification, diagnosis, methods of treatment

Abstract

This article aimed to familiarize the reader with the features of classification, diagnosis, and treatment methods of posterior pelvic ring injuries. It presents a review of literatures from PubMed (MEDLINE) and eLibrary investigating posterior pelvic ring injuries. A total of 67 scientific papers were covered. Modern aspects of classification, diagnostics, and surgical methods of treatment of the posterior pelvic ring injuries were analyzed. However, the classification of posterior pelvic injuries remains a difficult problem. Currently, various classifications of sacral fractures have been proposed, but sacral fractures cannot be considered separately from the entire pelvic ring because it is not only a part of the spine but also of the pelvis. The gold standard diagnostic modality of a patient with suspected pelvic ring damage is computed tomography, which reduces the frequency of missed or delayed diagnosis of pelvic injuries. Spino-pelvic fixation in combination with iliosacral screws or plate (triangular osteosynthesis) is the most stable technique for the stabilization of the dorsal pelvic ring. However, the higher risks of failure of the postoperative wound and the risks of deep infection with subsequent removal of the metal fixator should be considered. In the absence of clinically significant displacement, but in the presence of pelvic ring instability, minimally invasive methods of the stabilization of the posterior pelvic ring are preferred.