Evaluation of The Use of a Cloverleaf Plate as a Sacroiliac Joint Plate for Treating Complex Sacroiliac Joint Injuries
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 10, Issue 2
Abstract
Background: Various fixation methods can be applied in sacroiliac injuries. Objective: To propose an alternative fixation method for sacroiliac joint injuries with a pre-contoured cloverleaf plate. Methods: We used a modified surgical technique with using a cloverleaf plate as a sacroiliac joint plate for treating a series of 7 patients with complex sacroiliac joint injuries in a single medical institute. The surgical technique was detailed described. Each patient was followed up with at the outpatient clinic after discharge at 2 weeks, 4 weeks, 12 weeks, and until bone union and pelvic ring stabilization. Results: All patients were followed up with for at least 6 months. There were no perioperative complications, such as nerve or vascular injury, a broken plate, loose screw and plate, and loss of reduction, due to the osteosynthesis operations. During the follow-up period, all fixations were maintained until early bone union. Conclusion: Fixation of a sacroiliac joint fracture with a cloverleaf plate is an alternative and new option that provides good fixation strength and economic efficiency.Sacroiliac joint injury is a common injury caused by high- energy trauma and it is associated with unstable pelvic ring injury [1-3]. This injury pattern causes rotational instability of the hemipelvis, and osteosynthesis operation with internal fixation is always necessary to restore posterior pelvic ring stability [4]. The options of fixation for sacroiliac joints include iliosacral (trans- iliac/trans-sacral) screw by closed or open reduction [2, 3, 5, 6], open reduction and internal fixation with two orthogonal plates ventrally [4], and even triangular osteosynthesis for more complex and vertically unstable fractures [7,8]. The choice of fixation should be individualized according the type of pelvic injury. In the present report, we propose a technical modification whereby the stability from fixation can be improved easily without surgeons having to resort to using multiple plates. By using a cloverleaf plate to stabilize the sacroiliac joint, the area of contact is broadened and acts as a single implant. We describe the use of this technique in our small case series of 7 patients.
Authors and Affiliations
Winson Low Min Teng, Yung Heng Hsu, Ying Chao Chou, Yi Hsun Yu
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