OBJECTIVETo evaluate the biomechanical personality of the sacroiliac anatomy type Bar-plate system (SABP), which was of fixation usage to the fracture or dislocation of the sacroliliac joint.

METHODSTwenty fresh and freeze cadaver pelvises were prepared with pelvic fracture model,compared with different internal fixation systems such as Galveston technique, transiliac rod fixation, reconstruction plate and sacroiliac joint screws using experimental stress analysis methods,and then the stability of the pelvic was obtained and evaluated.

RESULTSUsing new SABP system to treat pelvic sacroiliac joint fracture and dislocation was higher 10%, 11%, 16%, 21% in the strength; more 12%, 14%, 21%, 31% in rigidity; less 13%, 14%, 22%, 25% in straining;less 10%, 12%, 16%, 20% in shifting than the Galveston technique, transiliac rod fixation, reconstruction plate and sacroiliac joint screws, with remarkable statistic difference (P < 0.05), and it was even better than cadaver pelvis.

CONCLUSIONTo treat pelvic facture, the fixation with new SABP system is of better strength, rigidity and stability, and the SABP system is an ideal new application.

Adult ; Biomechanical Phenomena ; Bone Plates ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Internal Fixators ; Joint Dislocations ; physiopathology ; surgery ; Middle Aged ; Sacroiliac Joint ; injuries ; surgery

PURPOSE: To analyze the effectiveness of anterior pelvic plating and subsequent percutaneous sacroiliac joint screw fixation in patients with unstable pelvic ring injuries. MATERIALS AND METHODS: Thirty-two patients were included with twenty-one males and eleven females. The mean age was 41 years (range, 19-76). The mean follow-up period was 51 months (range, 36-73). According to AO-OTA classification, there were 11 cases of B2 injuries, 8 cases of B3 injuries, 9 cases of C1 injuries, 2 cases of C2 injuries and 2 cases of C3 injuries. In the posterior lesions, there were 20 cases of sacral fractures and 12 cases of sacroiliac joint disruptions or dislocations. Anterior pelvic plating and subsequent percutaneous sacroiliac joint fixation were performed. RESULTS: The clinical results were 16 cases of excellent, 10 cases of good, 4 cases of moderate and 2 cases of poor functional results. The 2 cases out of 7 moderate reductions had poor functional results with residual neurologic symptoms. The radiological results were 16 cases of anatomic, 9 cases of nearly anatomic and 7 cases of moderate reduction. All patients were healed except 3 cases of nonunion at the pubic ramus. The complications encountered were 3 cases of screw loosening, 2 cases of anterior plate breakage and 1 case of postoperative infection. CONCLUSION: In patients with unstable pelvic ring injuries, anterior pelvic plating and subsequent percutaneous sacroiliac joint screw fixation may be a useful surgical option. The radiological results and residual neurologic symptoms had effects on its functional results.
Adult ; Aged ; Female ; Fracture Fixation, Internal/*methods ; Humans ; Male ; Middle Aged ; Pelvic Bones/*injuries/*surgery ; Sacroiliac Joint/*injuries/*surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate characteristics of treating dislocation and fracture of sacroiliac joint through anterior and posterior approaches.

METHODSBetween January 2006 and September 2012, 39 patients with dislocations and fractures of sacroiliac joint were treated with operation. There were 28 males and 11 females, aged 12 to 64 (mean, 41.3) years old. Seventeen cases were chosen through anterior approach, 13 cases through posterior and 9 cases were combined with anterior and posterior approaches. The anterior approach were made with supine position, performed open reduction, and two plates with 4 holes were used as internal fixation for arthrodesis of sacroiliac joint after reduction; while posterior approach prone position, close or open reduction was performed, and one or two partial thread lag screws, which with 7.3 mm in diameter and 60 to 75 mm in length, were penetrated via sacroiliac joint for fixation under X-ray. Postoperative complications were observed, Matta and Majeed scoring were used to evaluated currative effects.

RESULTSAll patients were followed up from 6 to 36 months. The patient could sit on the bed 2 to 4 weeks after surgery and walk with a crane 6 weeks' later. No breakage or loosening of screw occurred during follow-up. In all but one case with old sacral iliac fractures reducted poor, others obtained good opposition. According to Matta's criteria, 30 cases got excellent results, 8 good and 1 fair. According to Majeed's funtional standard, 14 patients got excellent results, 20 good 4 fair and 1 poor.

CONCLUSIONTreating dislocation and fracture of sacroiliac joint through anterior and posterior approaches can obtain good effects. However, anatomic location, fracture types, degree of displacement, the rate of preoperational reduction, vulnerability assessment of operation and fixation strength should be considered.

Adolescent ; Adult ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Internal Fixators ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Sacroiliac Joint ; injuries ; surgery ; Young Adult

OBJECTIVETo introduce the operation indication, operation fashion, operation time, mainipulation point, and treatment effect of pelvic ring disruptions with percutaneous fixation.

METHODSFifty-eight patients with pelvic ring disruptions were treated with sacroiliac screws, pubic ramus screws or pubic tubercle screws and iliac wing screws, and the effects was evaluated.

RESULTSAmong the 58 patients, the result of reductions in 52 cases was satisfied, 6 cases was dissatisfied; fracture point in 57 cases was healed up, 1 case disconnect; vessel and nerve was not injured in 56 cases, S(1) nerve root was injured in 2 case, bequeathing anaesthesia of lower limbs and saddle area.

CONCLUSIONSThe technique with percutaneous fixations is minitraumatic and reliable to fix the pelvic ring disruptions with little bleeding. These percutaneous techniques have a good outlook. Bone tractions with big weight before operation make for reductions in operation.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Pubic Bone ; surgery ; Retrospective Studies ; Sacroiliac Joint ; surgery ; Treatment Outcome

OBJECTIVESTo research radiographic anatomy of the main structure of the pelvic Teepee view, including its azimuth direction and view anatomy structure.

METHODSFrom June 2013 to June 2014 adult pelvic CT examination results were filtered, excluding skeletal deformities and pelvic osseous destruction caused by tumors, trauma, etc. The data of 2.0 mm contiguous CT scan of 9 adults' intact pelves was,selected and input into Mimics 10.01 involving 7 males and 2 females with an average age of (41.2±10.3) years old. Utilizing the software, the 3D CT reconstructions of the pelves were completed. Setting the transparency being high,the pelvic 3D reconstructions were manipulated from the pelvic anteroposterior view to the combined obturator oblique outlet view and fine-tuned till the regular Teepee-or teardrop-shaped appearance emerges. Cutting tools of the software were at the moment applied to separate the "Teepee" from the main pelvis for each reconstruction. Then the "Teepee" and the rest (main) part of the pelvis were displayed in different color to facilitate the analysis on the Teepee, iliac-oblique, and anteroposterior views.

RESULTSThe "Teepee" started from the posterolateral aspect of the anterior inferior iliac spine and finished at the cortex between the posterior superior iliac spine and the posterior inferior iliac spine in a direction of being from caudal-anterior-lateral to cranial-posterior-medial. The radiographic anatomical composition of the "Teepee" contained one tip, one base,and two aspects. With the inner and outer iliac tables being the inner and outer aspects of the "Teepee", the tip is consequently formed by their intersection. The base is imaged from the cortex of the greater sciatic notch. The medial-inferior-posterior portion of the "Teepee" contains a small part of sacroiliac joint and its corresponding side of bone of the sacrum.

CONCLUSIONSThe "Teepee" is a zone of ample osseous structures of the pelvis, aside from a small medial-inferior-posterior portion, the main zone of which can be accepted as a safe osseous zone for the anchor of implants stabilizing certain pelvic and acetabular fracture patterns. The Teepee view can be utilized as guidance for the safe percutaneous insertion of such implants.

Adult ; Female ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; anatomy & histology ; diagnostic imaging ; injuries ; surgery ; Sacroiliac Joint ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo study the percutaneous lag screw internal fixation of LX technique for sacroiliac joint diseases or injuries.

METHODSThere were 38 patients (25 male and 13 female) with an average age of 35.6 years ranged from 18 to 59 years. Among them, thirty-one cases with trauma of Tile B type, five cases with sacroiliitis and two cases with sacral cystis degeneration. There were 11, 15, 5 cases of Tile B1, B2, B3 type respectively. Pelvic anterior-posterior radiography and spiral computed tomography (CT) were undertaken for all patients. Axis planar, coronal planar, sagittal planar and curve planar of sacral reconstruction of spiral CT images were obtained for every patient. There were 28 cases with delitescence posterior ring injury. All these patients were performed percutaneous lag screw fixation procedures of LX technique under epidural anesthesia. Localization with spiral CT guidance was performed by the radiologist using spiral CT followed by the orthopaedic surgeon. Percutaneous fusion of sacroiliac joint was performed for seven patients who suffered from sacroiliac joint diseases.

RESULTSThe blood loss were from 25 to 70 ml (means 36 ml) during operation. All patients were followed up for 3 to 39 months (means 15.6 months). There were no postoperative complications such as infection, fracture nonunion, iatrogenic injuries of nerve and blood vessel, breakage and slippage of fixtors. According to the evaluation of pelvic injuries, the results of imageology were excellent in 34 cases and good in 4, the results of clinical were excellent in 32 and good in 6.

CONCLUSIONPercutaneous lag screw internal fixation of LX technique minimizes operation injury during a short procedure with few subsequent complications and allows early mobilization of the patients. That is an ideally safe and effetive operation technique for the sacroiliac joint diseases and injuries.

Adolescent ; Adult ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Internal Fixators ; Male ; Middle Aged ; Sacroiliac Joint ; diagnostic imaging ; injuries ; surgery ; Tomography, Spiral Computed ; Treatment Outcome