Functional Outcome of Percutaneous Iliosacral Screw Fixation in Vertically Unstable Posterior Pelvis Fracture Dislocation

Pelvic ring injury is a serious traumatic condition which needs urgent haemodynamic stabilisation of the patient and reconstruction of the pelvic ring. Depending upon the type of force vectors causing the injury, both the anterior fracture and symphyseal separation as well as the posterior Sacroiliac fracture dislocation warrant surgical fixation. However in certain cases, patients recover with only the posterior stabilisation supplemented by pelvic binders. Percutaneous fixation of the Sacroiliac disruption is always better than the open reduction and internal fixation as it is minimally invasive with little blood loss and less tissue damage. It may be associated with neurovascular complications if proper procedures and techniques are not followed. Per-operative C arm visualisation in various planes are mandatory for proper screw trajectories and to avoid complications. Usually 6.5 mm partially threaded Cannulated cancellous screws with washers are used for Sacroiliac dislocations, which require compression. A second screw may be added if needed into the S2 vertebral body. In sacral fractures, fully threaded Cannulated cancellous screws are used. Early reconstruction of the Pelvic ring helps in mobilising the patient, avoid complications like deep vein thrombosis, decubitus ulcers, infections and decreases the hospital stay duration. We are presenting in this study the functional outcome of 15 patients of Pelvic ring injury stabilized by Percutaneous Sacroiliac screws. Three patients also required anterior fixation of the symphyseal disruption. Rest are managed with posterior Sacroiliac fixation alone or few are supplemented by pelvic binders. Good to excellent functional recovery was recorded in majority of patients.