Displacement of an anterior pelvic ring fracture after L5, S1, and iliac screw fixation: a case report

Multiple fractures and fractures associated with underlying diseases commonly occur in older adults. The lower lumbar spine, sacrum, and pelvis are anatomically interconnected, and multiple simultaneous fractures frequently result from trauma. In this case, a patient with isthmic lumbosacral spondylolisthesis and severe osteoporosis sustained post-traumatic vertebral fractures involving the first and second sacral bodies, fractures of the left sacral ala, and fractures of the right anterior pelvic ring. During the initial conservative treatment period, the pelvic ring fracture remained stable. However, following lumbar, sacral, and iliac posterior fixation and fusion, the right anterior pelvic ring fracture worsened. Subsequently, conservative treatment without anterior pelvic fixation led to improvement. The purpose of this study is to review the evaluation and management of combined fractures involving the anterior pelvic ring through both a literature review and an analysis of this case.