Tratamiento de la fractura y luxación de la articulación sacroilíaca mediante un acceso anterior extraperitoneal

Abstract

Purpose To assess the outcome of addressing iliac wing fractures with involvement of the iliosacral joint by means of open reduction and internal fixation (ORIF) with plates, using an anterior extraperitoneal approach. Materials and methods We reviewed pelvic fractures treated in our hospital, collecting epidemiological data of those with a posterior injury pattern that corresponded to a fracture affecting the iliosacral joint. For all 14 cases included in the study, we carried out a functional assessment according to the Majeed scale, as well as a radiological evaluation according to the Matta classification. Results The functional assessment revealed that an excellent result was achieved in 8 cases and a good result in 5. A poor outcome was obtained in one single case. According to the postoperative radiological evaluation, reduction was excellent in 10 cases and good in the remaining 4. There was no loss of reduction or any major complications. Conclusions The technique described in our paper affords sufficient stability for fracture healing and it is associated with a low incidence of complications. It is especially indicated for multiple-trauma patients where the only position recommended in the supine one, for cases where the posterior soft tissues are compromised, and for instances when an open reduction of the fracture is needed.