Evaluation of closed reduction and screw fixation in lag fashion of sacroiliac fracture-luxations

Objective-To evaluate outcome by radiographic assessment after closed reduction and percutaneous screw fixation in lag fashion of sacroiliac fracture-luxations in dogs. Study Design-Retrospective study. Animals-Dogs (n=24) with sacroiliac fracture-luxations. Methods-Medical records (1999-2006) and radiographs of 24 dogs (29 fracture-luxations) that had stabilization of sacroiliac fracture-luxation by fluoroscopic-guided closed reduction and percutaneous screw fixation in lag fashion were reviewed. Signalment, body weight, number, and location of all concurrent injuries and implants used for repair were recorded. Radiographs were used to evaluate the accuracy of screw placement in the sacral body, screw depth/sacral width ratio, reduction of the sacroiliac joint, pelvic canal diameter, and hemipelvic canal width. Radiographic re-examination (range, 4 to > 8 weeks postoperatively) was available for evaluation. Results-Mean screw depth/sacral width ratio on immediate postoperative and re-examination radiographs was 64% and 61%, respectively. Mean percentage reduction of the sacroiliac joint on immediate postoperative and re-examination radiographs were 91% and 87%, respectively. Pelvic canal diameter ratio demonstrated successful restoration of the pelvic canal. Hemipelvic canal width ratio documented successful closed reduction repair independent of concurrent pelvic injuries. Conclusion-Successful repair of sacroiliac fracture-luxations, determined by radiographic assessment, can be achieved by fluoroscopic-guided closed reduction and percutaneous screw fixation in lag fashion. Clinical Relevance-Fluoroscopic-guided closed reduction and percutaneous screw fixation in lag fashion of sacroiliac fracture-luxations is a minimally invasive technique that restores and maintains pelvic canal dimensions and should be considered as an alternative to open reduction or nonsurgical management of sacroiliac fracture-luxations. (C) Copyright 2008 by The American College of Veterinary Surgeons.