Kwang-Jun Oh; Jin-Ho Choi

doi:10.12671/jkfs.2013.26.3.184

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Original Article
Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint: Kwang-Jun Oh, M.D., Ph.D., Jin-Ho Choi, M.D.; Journal of the Korean Fracture Society 2013;26(3):184-190.
DOI: https://doi.org/10.12671/jkfs.2013.26.3.184
Published online: July 15, 2013

Department of Orthopedic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

Address reprint requests to: Kwang-Jun Oh, M.D., Ph.D. Department of Orthopedic Surgery, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea. Tel: 82-2-2030-7360, Fax: 82-2-2030-7369, damioh@gmail.com

• Received: October 27, 2012 • Revised: January 9, 2013 • Accepted: April 25, 2013

This is anOpen Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
To evaluate the radiological and clinical outcomes of intrapelvic anterior plate fixations for Day Classification Type II crescent fracture-dislocations of sacroiliac joints.
Materials and Methods
Ten patients who had undertaken the surgical treatment for the sacroiliac joint from 2006 to 2012 were enrolled in this study. All cases fell into Type II by Day Classification for sacroiliac joint injuries. For surgical treatments, the plate fixation through the intra-pelvic anterior approach was first performed for all cases and anterior ring fixation was performed in 4 cases with more severely displaced anterior pelvic ring injuries. Then, radiological and clinical evaluation was implemented.
Results
The bone union was observed from all patients whom performed the surgical fixation. In the radiological results, 9 cases with the anatomic and nearly-anatomic reductions were observed. Out of the 10 cases which performed the rotational displacement analysis, there were 3 excellent cases, 6 good cases and 1 fair case. The 10 cases that performed the deformity index and vertical displacement analysis, less variations were observed in the anterior ring fixations after intra-pelvic anterior plate fixation group. According to the clinical results, 4 excellent cases, 3 good cases, and 3 moderate cases were observed.
Conclusion
In the Type II crescent fracture-dislocation of sacroiliac joint, the intrapelvic anterior plate fixation achieved satisfactory anatomical reductions, radiological stabilities and clinical results.
Key words: Sacroiliac joint complex, Crescent fracture-dislocation, Surgical outcome

REFERENCES

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Fig. 1

Classification of crescent fractures according to Day et al. (Fig. 3D) with permission4).

Fig. 2

(A) Radiograph shows intra-pelvic anterior approach & plate fixation with anterior ring fixation.

(B) Radiograph shows intrapelvic anterior approach & plate fixation without anterior ring fixation.

Fig. 3

Reduction of fracture-dislocation was evaluated with a comparison of pre- and post-operative computed tomography scans. Pre OP: Preoperative, Post OP: Postoperative.

Fig. 4

Rotational displacement was evaluated with a comparison of pre- and post-operative computed tomography scans. Pre OP: Preoperative, Post OP: Postoperative.

Fig. 5

Deformity index was evaluated with a comparison of immediate postoperative (post-op) and last follow-up (f/u) plain X-rays. Radiograph showing measurements of deformity index (X-Y/X+Y), which takes obliquity of the exposure into account, was the calculated (X-Y/X+Y).

Fig. 6

Vertical displacement was evaluated with a comparison of immediate postoperative (postop) and recent follow-ups (f/u) of plain X-rays. Radiograph showing vertical displacement with the distance between the top of the iliac crests and a line perpendicular to the L5 reference line and the corrected displacement on the post-operative radiograph in the same patient.

Table 1

Summary of Cases

M: Male, F: Female. ^*Postoperative deformity index-final follow-up deformity index. ^†Postoperative vertical displacement-final follow-up vertical displacement.

Figure & Data

REFERENCES

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Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint

J Korean Fract Soc. 2013;26(3):184-190. Published online July 31, 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.3.184

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Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint

Fig. 1 Classification of crescent fractures according to Day et al. (Fig. 3D) with permission4).

Fig. 2 (A) Radiograph shows intra-pelvic anterior approach & plate fixation with anterior ring fixation. (B) Radiograph shows intrapelvic anterior approach & plate fixation without anterior ring fixation.

Fig. 3 Reduction of fracture-dislocation was evaluated with a comparison of pre- and post-operative computed tomography scans. Pre OP: Preoperative, Post OP: Postoperative.

Fig. 4 Rotational displacement was evaluated with a comparison of pre- and post-operative computed tomography scans. Pre OP: Preoperative, Post OP: Postoperative.

Fig. 5 Deformity index was evaluated with a comparison of immediate postoperative (post-op) and last follow-up (f/u) plain X-rays. Radiograph showing measurements of deformity index (X-Y/X+Y), which takes obliquity of the exposure into account, was the calculated (X-Y/X+Y).

Fig. 6 Vertical displacement was evaluated with a comparison of immediate postoperative (postop) and recent follow-ups (f/u) of plain X-rays. Radiograph showing vertical displacement with the distance between the top of the iliac crests and a line perpendicular to the L5 reference line and the corrected displacement on the post-operative radiograph in the same patient.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint

Table 1

Summary of Cases

M: Male, F: Female. ^*Postoperative deformity index-final follow-up deformity index. ^†Postoperative vertical displacement-final follow-up vertical displacement.

Table 1 Summary of Cases

M: Male, F: Female. ^*Postoperative deformity index-final follow-up deformity index. ^†Postoperative vertical displacement-final follow-up vertical displacement.