Closed reduction and percutaneous fixation of sacroiliac injuries

Unstable pelvic fractures, especially in polytraumatized patients, require an aggressive and well-planned therapeutic regimen. Combined anterior and posterior internal fixation is the optimal treatment for vertically and rotationally unstable fractures.1,2Iliosacral screws may be used for both sacral fractures and sacroiliac joint dislocations. Fixation has most commonly been carried out using an open posterior approach. Some authors have noted a high complication rate in association with posterior pelvic wounds. The major disadvantage of the posterior approach is the risk of impaired wound healing and subsequent infection with a combined incidence reported as high as 25% in one series.104, 107Percutaneous fixation of the posterior pelvic ring is used for complete disruptions of the SI joint and many sacral fractures that require stabilization.103,108,,113,114,106Fluoroscopy guided placement of iliosacral screws. Routt et al in1995 and again in 1996 discribed this technique of for sacroiliac disruption and sacral fracture, reported there outcome and complication.119CT-Guided Iliosacral Screw Placement. There are many papers that studies the result of CT-Guided Iliosacral Screw Placement. Some of the recent sudies: Blake-Toker, Anna-Maria(2001), van den Bosch EW, van Zwienen CMA, and van Vugt AB(2002).117,118,120.