Minimally Invasive Surgery for Unstable Pelvic Ring Fractures: Transiliac Rod and Screw Fixation

• Published in: Acta medica Okayama Vol. 74; no. 1; pp. 27 - 32
• Main Authors: Toda, Kazukiyo, Yagata, Yukihisa, Kikuchi, Takeshi, Takigawa, Tomoyuki, Ito, Yasuo
• Format: Journal Article
• Language: English
• Published: Japan 01.02.2020
• Subjects: sacral fracture; minimally invasive surgery; spinal fixation system; transiliac rod and screw fixation; pelvic ring fractures
• ISSN: 0386-300X
• DOI: 10.18926/amo/57949

Pelvic fractures occur with high-energy trauma, and the patient's clinical status is unstable. Although a number of surgical methods for unstable pelvic fractures are available, none can achieve strong fixation with minimal invasiveness. We describe a surgical transiliac rod and screw fixation (TIF) procedure that provides minimally invasive fixation using a spinal implant for unstable pelvic ring fractures, and we retrospectively analyzed the procedure's outcomes in 27 patients with type B or C1 fractures (based on the AO/ATO classification system). Small skin incisions are made above the posterior superior iliac spines on both sides. The ilium is partially resected, and two iliac screws are inserted on each side. The spinous process of the sacral spine is then shaved, and the iliac screws are connected to 2 rods, one placed caudal to the other. Corrective manipulation is performed at the fracture site, and the rods are connected with connectors. Favorable fracture reduction, defined as a rating of 'excellent' or 'good,' was achieved in 77.8% of the patients. Transiliac rod and screw fixation (TIF) will be a useful therapeutic option for unstable pelvic ring fractures.