Percutaneous Posterior Ilioiliac Pelvic Plating: Case Series and Surgical Technique

Summary: Pelvic ring injuries involving the posterior ring frequently require complex surgical solutions—particularly Tile C injuries. Despite various techniques available, there is no consensus gold standard for achieving stable fixation, particularly in complex injury patterns with lumbopelvic dissociation, severe posterior comminution, and/or severe sacral dysmorphism, or injuries requiring an open approach for reduction. Although biomechanical data demonstrate significant promise to percutaneous posterior pelvic plating, there is a paucity of literature examining its clinical application. This study introduces percutaneous posterior ilioiliac pelvic plating as a useful surgical technique for unstable posterior pelvic ring fractures including a case series of 11 patients treated with this technique, focusing on fixation stability, complication rates, and neurologic status. Incorporating this series with the existing literature, percutaneous posterior pelvic plating is presented as a viable, effective option for managing these complex injuries.