Abstract
S-I joint disruptions are high-energy injuries, often resulting in prolonged morbidity with conservative management. Operative management in contrast permits early ambulation and avoids prolonged recumbency.
Ten patients of type C disruptions of S-I Joint were managed by operative stabilization after their haemo-dynamic stabilization. While four of the patients were managed by anterior plate fixation, percutaneous lag screw was used in the remaining six to stabilize the SI joint disruption. Supplementary external fixation was used in four of the patients in addition to percutaneous lag screw. Patients were evaluated using Matta’s criteria based on parameters like pain, walking ability, range of hip movements and radiographic findings. None of the patients complained of pain and normal walking. Good radiological reduction was achieved in all the ten cases, although secondary displacement was seen in one patient of anterior plating.
Plate fixation on anterior aspect of S-I joint provides less protection from vertical instability on account of possibility of axial rotation, as there is space for only one screw on the sacral side of the joint. In contrast percutaneous screw provides adequate stability against vertical displacement, as it is placed at right angle to the direction of displacement. Supplementary external fixation provides additional stability in the horizontal direction and makes it possible to permit early ambulation. Minimal dissection and little blood loss are the other advantages of this procedure over plate fixation. However the procedure is technically demanding due to the presence of vital anatomical structures in the vicinity.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
