Sacroiliac fixation: a new technique after pelvic trauma

We propose a new technique for sacroiliac fixation for the treatment of pelvic fracture with vertical and horizontal instability (Tile class C). This fixation technique allows control of vertical displacement while allowing, if needed, a certain degree of movement in the horizontal plane to facilitate reduction of anterior lesions. The technique involves insertion of two sacral screws, one in S1 and one in S2, and two iliac screws. The iliac screws are inserted in the posterior iliac crest through two sacroiliac connectors placed on a rod linking the two sacral screws. Vertical displacement is controlled by blocking the screw heads on the connecting rod. If needed, a certain degree of horizontal mobility of the half pelvis can be allowed by loosening the connectors on the rods. This technique was used for 4 patients. Anatomic reduction was achieved and no secondary movement of the osteosynthesis material nor secondary displacement were observed. The quality of the fixation allowed rapid weight bearing in the standing position and early walking without crutches. This type of fixation can only be used for type C12 fractures in the Tile classification.