新月形骨折病理解剖学分型的建立及应用

目的：通过对新月形骨折的深入研究,提出新月形骨折病理解剖学分型,并探讨其对手术治疗的临床指导意义。方法：回顾性分析2018年2月至2020年9月收治的65例新月形骨折患者的临床资料,男40例,女25例;年龄17～70岁,平均（47.4±12.7）岁。根据骨盆新月形骨折线与骶骨翼、骶骨侧嵴等解剖标志的关系将新月形骨折分为3型,对不同的骨折分型选择合适的内固定方式和手术入路。术后采用Matta影像学标准评价骨盆骨折复位质量,末次随访时采用Majeed功能评分对骨盆功能进行评定。结果：根据新月形骨折病理解剖学分型：Ⅰ型16例（24.6%）,Ⅱ型30例（46.2%）,Ⅲ型19例（29.2%）。65例患者术后随访12～26个月,平均（14.6±3.2）个月。根据Matta影像学标准：优59例,良6例,可0例,差0例,优良率100%。Majeed功能评分优62例,良3例。结论：根据骶髂关节解剖特点,尤其是骶骨侧方骨嵴隆起的位置对新月形骨折进行分型,并据此选择手术方式的可行性较好,临床效果满意。     

经后侧入路手术治疗骨盆新月形骨折

目的探讨经后侧入路手术治疗骨盆新月形骨折的疗效。 方法 2007年4月至2010年1月采用经后侧入路手术治疗12例骨盆新月形骨折患者，男8例，女4例；年龄21 ～55岁，平均31.3岁；左侧6例，右侧6例。致伤原因：交通伤8例，高处摔伤3例，重物压伤1例；对于骨盆，均为侧方的挤压暴力。骨折根据Tile分型：B2.1型8例，B2.2型4例。12例患者均采用经后侧入路行切开复位内固定治疗。受伤至手术时间为3～9d，平均6.2d。记录手术时间、术中失血量、手术纠正骨盆后环骨折移位情况、骨折愈合时间及Hannover骨盆评分。 结果本组患者手术时间平均为(172.5±34.1)min(120 ～240 min)，手术失血量平均为(412.5±128.1) mL(250 ～700 mL)，手术纠正移位平均为(11.7±4.6) mm(6～21 mm)，12例患者复位结果均为优。10例患者术后获12 ～20个月（平均16.3个月）随访。X线片示所有患者骨折均获愈合，愈合时间平均为(3.1±0.3)个月(3～4个月)，无骨折复位丢失及内固定失效发生。按照Hannover骨盆评分标准评定疗效：临床症状恢复：优7例，良3例；重返社会能力：完全重返8例，部分重返2例。 结论经后侧入路手术治疗骨盆新月形骨折是一种较好的选择，可以取得良好疗效。     

螺旋CT重建技术在骨盆环骨折中的诊治价值

目的:探讨螺旋CT二维多平面重建(MPR)、三维重建(3D)对骨盆环骨折的诊断、分型及治疗的临床价值。方法:回顾性分析2004年4月至2009年4月收治的有完整的X线DR(digital radiography)片、螺旋CT片影像资料的57例骨盆环骨折患者,根据Tile分类,本组病例A型38例,B型12例,C型7例。对A型患者采取保守治疗,对B、C型患者全部采取手术治疗,根据骨折移位情况,采用开放复位内固定或经皮行骶髂关节空心螺钉内固定术。术后3d～27个月内进行随访,利用螺旋CT检查进行术后疗效评估,对其术前术后的DR片、螺旋CT的3D、MPR的重建图像进行对照分析。结果:57例骨盆环骨折患者中,5例骨盆后环骨折患者的X线DR片诊断为可疑骨折,9例骨盆后环骨折X线DR片漏诊,3例骨盆前环骨折患者的X线DR片诊断为可疑骨折,3例骨盆前环骨折患者的X线DR片漏诊,后经螺旋CT检查予以修正。术后影像学评价优15例,良3例,差1例;临床评价优16例,良3例。结论:螺旋CT的MPR、3D的重建图像对骨盆环骨折的诊断、分型及临床治疗评估具有重要的临床价值。     

经骶骨翼髂骨螺钉腰椎-骨盆固定术治疗骶骨骨折

目的探讨经骶骨翼髂骨(sacral ala-iliac, SAI)螺钉腰椎-骨盆固定或三角固定术治疗骶骨骨折的临床疗效。方法回顾性分析2019年12月至2020年6月期间采用SAI螺钉腰椎-骨盆固定或三角固定术治疗骶骨骨折12例患者的病历资料, 男3例, 女9例;年龄(32.6±15.0)岁(范围13～52岁)。致伤原因:坠落伤11例, 交通伤1例。骶骨骨折Denis分型:Ⅱ型4例, Ⅲ型8例。AO分型(Tile-Muller):C1.3型4例, C3.3型8例;其中C3.3型8例的改良Roy-Camille和Strange-Vognsen分型:Ⅱ型2例, Ⅲ型6例。8例C3.3型患者按Gibbons骶神经损伤评分:3分6例, 4分2例;4例C1.3型无神经损伤。6例患者合并骨盆前环损伤。受伤至手术时间为(19.3±9.2)d(范围6～32 d)。待生命体征平稳后行椎板切除减压和骶神经根减压、骨折复位、SAI螺钉腰椎-骨盆固定或三角固定术, 骨盆前环根据损伤情况决定固定方式。根据Matta标准评价术后骨折复位情况, 末次随访时采用Majeed评分系统和Gibbons骶神经损伤评分系统对...     

骶骨骨折合并神经损伤的诊断与治疗

[目的]总结骶骨骨折合并骶神经损伤的诊断与治疗方法。[方法]1999～2004年收治骶骨骨折合并神经损伤患者12例,男9例,女3例。所有患者经详细体格检查及X线片、CT、MRI扫描等获得确诊。依据影像学资料进行Denis分型：Ⅰ型2例,Ⅱ型6例,Ⅲ型4例。不同分型采取相应的治疗方法：Ⅰ、Ⅱ型骨折先行骨盆牵引等保守治疗,观察4～6周,若症状改善不显著则转为手术治疗;Ⅲ型骨折尽早行后路骶椎管减压神经根探查松解手术;陈旧性Ⅱ、Ⅲ型骨折只要存在神经损伤表现,仍主张手术。共保守治疗7例,手术治疗5例。[结果]12例患者经6个月～3年随访,2例Ⅰ型骨折,6例Ⅱ型骨折患者完全恢复。4例Ⅲ型骨折患者中,1例完全恢复,2例显著改善,1例略有恢复。[结论]骶骨位置隐蔽,骨折所造成的神经损伤症状不明显,临床容易漏诊,需详细体检并结合影像学检查以提高确诊率。不同分型骨折可采用不同的治疗方法,手术方式以后路骶管减压骶神经松解为宜,陈旧性骨折只要存在神经损伤症状就有手术探查必要。     

腰髂联合外支架固定对骨盆前环伴经骶骨Denis-II骨折的治疗

【摘要】〓目的〓探讨腰髂固定联合外固定支架对经骶骨骨折骨盆前后环损伤的手术治疗方法和疗效。方法〓采用后路切开复位腰髂固定联合前路外固定支架治疗经骶骨骨折骨盆前后环损伤病人11例,骨盆骨折tile分型均为Tile-C型,C1型8例,C2型2例,C3型1例。经骶骨骨折Denis分型Ⅱ型。结果〓随访时间11~64月,平均36.4月。均获骨性愈合,Majeed评分平均84分。优6例,良4例,优良率90.9%。术后切口感染1例,外固定架钉道感染1例,清创拆除支架换药后愈合。结论〓腰髂固定联合外固定支架可有效稳定骨盆环,手术创伤小,效果可靠。是治疗经骶骨骨折骨盆前后环损伤的可靠方法。     

骨盆后环损伤分型的临床意义

骨盆骨折前环后环同时损伤时,治疗应以后环为主,由于后环损伤可使骨盆失去稳定性,以致骨盆移位变形。故对这种损伤应以后环损伤为主进行骨折分型。后环损伤包括:骶髂关节脱位,骶髂关节韧带损伤,骶孔直线骨折,髂翼后部直线骨折。作者按照受伤时的体位和骨盆变形的不同,将后环损伤分为:压缩型,分离型和中间型。 压缩型:当骨盆受到侧方打击时,一侧髂骨向内压缩(内旋、内翻),先致耻坐骨枝骨折,打击力继续作用,可使骨盆后环的一处发生骨折     

髂骨截骨治疗陈旧性Tile C型骶骨骨折一例报告

目的 探讨髂骨截骨治疗陈旧性Tile C型骶骨骨折的的可行性与有效性.方法 2009年8月收治1例骨盆骨折[AO分型C2型,包括骶骨骨折(Tile C型、Denis I型)、双侧髂骨、耻骨骨折]等多发伤1个月的患者,男性,50岁.术前查体:双下肢外旋畸形,左下肢短缩2 cm,双髋及骨盆区压痛,双髋关节不能活动.双下肢感觉、血供良好,远端活动良好.X线片、CT片显示:左侧骨盆向上移位.在全身麻醉下行左耻骨上、下支骨折切开复位、左侧髂骨截骨、下拉左侧骨盆、钢板螺钉内固定术等治疗.结果 骨盆手术时间约3h,术中出血量约400 mL.术后切口一期愈合,无神经损伤表现,无感染、深静脉血栓形成及肺栓塞发生.术后1年随访,X线片证实骨折愈合良好,患者已弃拐行走,无痛感,无跛行.结论 髂骨截骨是治疗陈旧性Tile C型骶骨骨折的一种有效且相对安全的术式.     

“开书样”不稳定骨盆骨折的治疗进展

<正>骨盆环损伤在临床上比较少见,其发生率约占全身骨折的0.3%～8.2%[1-2]。"开书样"骨盆骨折是一种由前后暴力及挤压造成的骨盆外旋转不稳定骨折,其常常会发生骨盆前环的骨折或耻骨联合分离,并且造成骨盆环的外旋不稳定。在Tile分型中属于Tile B1型损伤,Tile B1型损伤相较于Tile B2、Tile B3型骨折,其术后预后疗效差,并发症多,是最严重的B型损伤[3]。目前,临床上对于"开书样"骨盆骨折后环出现损伤的手术治疗常常行     

盆下型骨盆倾斜的分型与治疗

目的：对盆下型骨盆倾斜进行临床分型和分型治疗。方法：盆下型骨盆倾斜以畸形演变机制为基础，结合临床表现分为2个类型，即髋关节周围挛缩型，下肢不等长型。结果：作者从1987年起对1085例骨盆倾斜进行了分型治疗，其中在髋关节周围挛缩型中，患侧肢体髋关节周围挛缩型58例，健侧肢体髋关节周围挛缩型232例；在下肢不等长型中，代偿性骨盆倾斜762例，固定型骨盆倾斜33例，采用分型治疗方法，骨盆倾斜纠正满意。     

移位的耻骨下支骨折与骨盆后环损伤关系的临床观察

目的 :探讨移位耻骨下支骨折和骨盆后环损伤之间关系。方法 :回顾性研究2012年8月至2015年8月就诊且有完整资料的51例耻骨支骨折患者,男27例,女24例;年龄9~90岁,平均(49.1±19.0)岁;受伤到就诊时间从0.3~48 h,平均10.1 h;Tile骨盆骨折分型:A型28例,B型17例,C型6例;详细评估患者X线片和CT影像学资料,明确是否合并骨盆后环损伤;同时将耻骨支骨折分为耻骨下支移位组、耻骨下支无移位组、耻骨上支移位组和耻骨上支无移位组,确定各组合并骨盆后环损伤比率并进行比较。结果:26例患者存在耻骨下支移位骨折,均发现骨盆后环损伤;20例患者存在耻骨下支无移位骨折,6例(30%)合并骨盆后环损伤;28患者存在耻骨上支移位骨折,22例(78.5%)合并骨盆后环损伤;12例患者存在耻骨上支无移位骨折,5例(41.6%)合并骨盆后环损伤;合并骨盆后环损伤比率方面,移位耻骨下支骨折组与无移位耻骨下支骨折组比较,两组差异有统计学意义(P=0.028 80.05);与耻骨上支无移位骨折组和移位骨折组比较,差异均无统计学意义(P=0.055 80.05;P=0.168 30.05),但合并骨盆后环损伤比率均明显高于两组(100%vs 41.6%,78.5%)。结论:移位的耻骨下支骨折合并出现骨盆后环损伤率最高,往往提示骨盆后环损伤可能,移位的耻骨下支骨折是骨盆后环损伤的间接证据。     

A pelvic fracture model for the assessment of treatment options in a laboratory environment

BACKGROUND: Optimal prehospital and clinical management of patients with severe pelvic trauma is controversial. Prospective evaluations of different treatment strategies have not been performed and treatment is currently not evidence-based. The purpose of the present study was to develop a porcine model of reproducible severe pelvic trauma for subsequent laboratory trials. METHODS: The study was performed on 13 juvenile porcine cadavers. Pelvic fractures were created by applying a pure anterior-posterior compression load to the pelvic ring using a servohydraulic material testing machine. Fracture patterns were classified according to the Young-Burgess classification and the Tile classification using postfracture CT scans including 3D-reconstructions. RESULTS: Disruptions of the posterior pelvic ring segment were unilateral in 12 cases and bilateral in one case transforaminal vertical sacrum fractures. Injuries of the anterior ring segment were obturator ring fractures bilateral, ipsilateral or contralateral to the injury of the posterior ring segment. According to the Tile classification this resulted in 12 type C1 and 1 type C3 fractures. In the Young classification all injuries were classified as type APC III. In six cases transverse process fractures were found ipsilateral to the posterior ring disruption. Initial force drops indicating bony or ligamentous injuries occurred at mean forces of 4030 +/- 269N (range, 3617-4374N). CONCLUSION: The present model was able to create reproducible unstable pelvic fractures and can be used for controlled laboratory trials to study the management of patients with pelvic fractures.     

Acute Pelvic Fractures: I. Causation and Classification

Acute pelvic fractures are potentially lethal, even with modern techniques of poly-trauma care. The appropriate treatment of such fractures is dependent on a thorough understanding of the anatomic features of the pelvic region and the biomechanical basis of the various types of lesions. Although the anterior structures, the symphysis pubis and the pubic rami, contribute approximately 40% to the stiffness of the pelvis, clinical and biomechanical studies have shown that the posterior sacroiliac complex is more important to pelvic-ring stability. Therefore, the classification of pelvic fractures is based on the stability of the posterior lesion. In type A fractures, the pelvic ring is stable. The partially stable type B lesions, such as "open-book" and "bucket-handle" fractures, are caused by external- and internal-rotation forces, respectively. In type C injuries, there is complete disruption of the posterior sacroiliac complex. These unstable fractures are almost always caused by high-energy severe trauma associated with motor vehicle accidents, falls from a height, or crushing injuries. Type A and type B fractures make up 70% to 80% of all pelvic injuries. Because of the complexity of injuries that most often result in acute pelvic fractures, they should be considered in the context of polytrauma management, rather than in isolation. Any classification system must therefore be seen only as a general guide to treatment. The management of each patient requires careful, individualized decision making.     

外固定架联合髂腰固定术治疗垂直不稳定型骨盆骨折

目的 探讨应用外固定架联合髂腰固定术治疗垂直不稳定型骨盆骨折的临床效果.方法 对2008年1月至2009年3月收治的9例垂直不稳定型骨盆骨折患者进行手术治疗.男4例,女5例;年龄19～56岁,平均37岁.9例均为Tile C型骨折,其中C1.2型3例,C1.3型6例.采用后路患侧下腰椎旁切口入路,垂直移位复位后,椎弓根钉棒系统固定L4.5椎体和髂后上棘,前路双侧髂前上棘组合式外固定器固定.结果 9例患者术后获得12～18个月随访,平均14.3个月.术后X线片均示骨盆骨折复位满意,后环形态恢复良好;根据Matta骨盆骨折复位评定标准,优6例,良3例.术后2例患者骶丛损伤压迫症状解除,未出现医原性神经、血管损伤.下肢行走、蹲屈功能恢复满意.术后12个月Majeed评分:优7例,良2例.结论 外固定架联合髂腰固定术治疗垂直不稳定型骨盆骨折疗效满意,且具有操作简便、并发症少的特点.

Abstract：

Objective To evaluate the clinical outcomes of external fixator with lumbopelvic distraction spondylodesis in treatment of vertically unstable pelvic fractures. Methods From January 2008 to March 2009, 9 patients (4 males and 5 females) with a vertically unstable pelvic fracture were treated with modular external fixator with lumbopelvic distraction spondylodesis. According to the classification of Tile, 9fractures were classified as type C. This fixation construct comprises a vertical lumbopelvic distraction component which fixed L4.5 and the posterior superior iliac spine and a transverse fixation which fixed anterior iliac spine with external fixator. Results All patients were followed up 12-18 months after surgery, with an average of 14.3 months. Postoperative X-ray showed satisfactory reduction of pelvic fracture. Pelvic fractures healed in all patients without loss of reduction 3-6 months after operation. According to Matta reduction evaluation criteria, 6 patients were excellent and 3 good. For the two patients with sacral neurological injuries,appropriate surgical decompression was performed to improve the symptom and minimize the deformity. No iatrogenic complications of neurovascular injury occurred. Patients now walk unassistedly without pain in the waist or legs, and with no shortening of lower limbs or claudication. By considering symptom and satisfactory scores, the Majeed functional assessment revealed that seven patients had excellent results and two good at one year. Conclusion External fixator with lumbopelvic distraction spondylodesis that allowed early mobilization and ambulation, with general applicability and definite safety, is an effective surgical technique for the treatment of vertically unstable pelvic fracture.     

Fixation with Si alar iliac screws for unstable injury to posterior pelvic ring北大核心CSCD

Objective To explore the fixation with S2 alar iliac screws (S2AI) for unstable injury to the pelvic posterior ring.Methods The clinical data of 18 patients were analyzed retrospectively who had been treated for unstable injury to the posterior pelvic ring by S2AI screw fixation at Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University and at Department of Orthopaedics and Traumatology, The First Affiliated Hospital to University of South China from September 2017 to December 2020.They were 8 males and 10 females, with an average age of 40 years (from 20 to 64 years).According to Tile classification, there were 3 cases of type B2, 10 cases of type CI and 5 cases of type C2.Sacral nerve injury was complicated in 3 patients (2 cases of Gibbons grade 11 and one of Gibbons grade m ) .Short-segment S1-S2AI fixation was used in 6 cases, contralateral Sj-SsAI fixation in one case, lumbar-pelvic fixation in 5 cases, and sacroiliac triangle fixation in 6 cases.The accuracy of S2AI placement was e-valuated by CT after operation according to the Shillingford method; the reduction quality of pelvic fractures and complications were documented.Results All the 18 patients were followed up for 19.8 months (from 12 to 36 months).Bony union was achieved in all fractures.A total of 21 S2AI were implanted in the 18 patients without intraoperative neurovascular injury.Postoperative CT found penetration into the iliac cortex by S2AI in 2 cases.According to the Malta criteria, the fracture reduction was excellent in 10 cases, good in 7 and fair in one.Of the 3 patients with preoperative sacral nerve injury, 2 with grade 11 injury recovered to grade I and one with grade IH injury recovered to grade 11 after operation.Superficial infection occurred at the incision site in 2 patients after operation, and complications such as protrusion, rupture or loosening of implants were observed in none of the patients.Conclusion S2AI fixation can be flexibly applied to various types of posterior pelvic ring injury and can provide the pelvic ring and the lumbosacral junction with rigid fixation, leading to a low complication rate. © The Author(s) 2022.     

Beckenringverletzung

Pelvic fracture, especially in combination with multiple trauma,can still lead to lifethreatening situations. Only clear inclusion criteria and decisions can ensure the survival of the patient, the key task being mechanical stabilization using external fixators or pelvic clamps with or without surgical intervention for hemostasis. The basis for problem-orientated management is a precise classification, which is based on conventional X-rays in emergency situations and detailed analysis of computed tomography for the planning of definitive surgical interventions. The classification groups postulated are stable pelvic fractures (type A), rotational unstable pelvic fractures (type B—partial stability of the posterior pelvic ring present), and translational instabilities (type C—with a complete disruption of the anterior and posterior pelvic ring). This classification leads to clear indications for pelvic ring stabilization as surgical interventions are only exceptionally indicated in type A fractures, stabilization of the anterior ring is sufficient for type B fractures, and combined posterior and anterior stabilization is necessary for treatment of type C fractures. Following these concepts and by using standardized procedures and implants, the high rate of enclosed anatomical healing can be achieved even after type C injuries. Nevertheless, the role of concomitant soft tissue injuries and scar formation is not clear as the origin of the frequently observed long-term clinical impairments even after anatomical reconstruction of the osteoligamentous structures.     

Pelvic fracture. Diagnostics and current treatment options]

Pelvic fracture, especially in combination with multiple trauma, can still lead to life-threatening situations. Only clear inclusion criteria and decisions can ensure the survival of the patient, the key task being mechanical stabilization using external fixators or pelvic clamps with or without surgical intervention for hemostasis. The basis for problem-oriented management is a precise classification, which is based on conventional X-rays in emergency situations and detailed analysis of computed tomography for the planning of definitive surgical interventions. The classification groups postulated are stable pelvic fractures (type A), rotational unstable pelvic fractures (type B--partial stability of the posterior pelvic ring present), and translational instabilities (type C--with a complete disruption of the anterior and posterior pelvic ring). This classification leads to clear indications for pelvic ring stabilization as surgical interventions are only exceptionally indicated in type A fractures, stabilization of the anterior ring is sufficient for type B fractures, and combined posterior and anterior stabilization is necessary for treatment of type C fractures. Following these concepts and by using standardized procedures and implants, the high rate of enclosed anatomical healing can be achieved even after type C injuries. Nevertheless, the role of concomitant soft tissue injuries and scar formation is not clear as the origin of the frequently observed long-term clinical impairments even after anatomical reconstruction of the osteoligamentous structures.     

有限切开内固定结合外固定器治疗Tile C型骨盆骨折

目的 探讨有限切开内固定结合外固定器治疗Tile C型骨盆骨折的临床价值.方法 采用有限切开内固定结合外固定器治疗Tile C型骨盆骨折28例,男17例,女11例;年龄21~52岁,平均34岁;合并神经损伤4例,失血性休克16例,其他部位骨折15例.按照Tile分型均为C型骨折,C1型15例,C2型9例,C3型4例.结果 28例中,23例复位满意,5例未完全复位,其中3例纵向移位≥1cm,2例横向分离移位(耻骨联合分离≥2cm,耻骨支分离≥1cm).骨折愈合时间2~5个月,平均3.2个月.2例切开复位后骶髂部皮肤发生浅层感染,培养为表皮葡萄球菌,选用敏感抗生素治疗后感染得到控制.3例外固定针孔感染.1例骶髂螺钉固定术后CT证实螺钉穿出S1A椎体前皮质.1例外固定支架固定螺钉穿出髂嵴外侧皮质.1例术后股外侧皮神经损伤.26例获得随访,随访时间18~58个月,平均48个月.根据Majeed制定评估标准,优17例,良7例,可2例,优良率92.3%.4例术前有神经损伤症状者,2例在术后4个月时完全恢复,2例未恢复.4例患者主诉腰骶部疼痛.结论 有限切开内固定可纠正不稳定骨盆骨折纵向移位,而横向移位可以使用外固定器复位固定.     

Injury to the pelvic ring. Diagnosis and current possibilities for treatment

Pelvic fracture, especially in combination with multiple trauma, can still lead to ife-threatening situations. Only clear inclusion criteria and decisions can ensure survival of the patient, the key task being mechanical stabilization using external fixators or pelvic clamps with or without surgical intervention for hemostasis. The basis for problem-orientated management is a precise classification, which is based on conventional X-rays in emergency situations and detailed analysis of computed tomography for the planning of definitive surgical interventions. The classification groups postulated are stable pelvic fractures (type A), rotational unstable pelvic fractures (type B -- partial stability of the posterior ring present), and translational instabilities (type C -- with a complete disruption of the anterior and posterior pelvic ring). This classification leads to clear indications for pelvic ring stabilization as surgical interventions are only exceptionally indicated in type A fractures, stabilization of the anterior ring is sufficient for type B fractures, and combined posterior and anterior stabilization is necessary for treatment of type C fractures. Following these concepts and by using standardized procedures and implants, the high rate of enclosed anatomical healing can be achieved even after type C injuries. Nevertheless, the role of concomitant soft tissue injuries and scar formation is not clear as the origin of the frequently observed long-term clinical impairments even after anatomical reconstruction of the osteoligamentous structures.     

Anatomical risks of using supra-acetabular screws in percutaneous internal fixation of the acetabulum and pelvis

We conducted a study to determine whether a lag screw placed percutaneously at the level of the pelvic brim for treatment of iliac fracture risks injury to the lateral femoral cutaneous nerve (LFCN). A 4-mm Kirschner wire (K-wire) was placed percutaneously into each of 8 human cadaveric hemipelvises (4 pelvises) at the level of the pelvic brim to represent the path of screw placement. Under fluoroscopic guidance, each K-wire was advanced from the anteroinferior iliac spine toward the posterior iliac crest. Cadavers were dissected at study end. Proximity of the LFCN to the percutaneously inserted K-wire was the main outcome measured. In 4 of the 8 hemipelvises, the LFCN was disrupted; in 3 hemipelvises, it was within 4 mm of the K-wire; in the last hemipelvis, it was 23 mm away. LFCNs varied anatomically from 1 to 5 branches; disruptions occurred more in LFCNs with multiple branches than in those with 1 branch. The results suggest considerable risk for injury to the LFCN during percutaneous fixation of iliac and acetabular fractures using a percutaneous screw at the level of the pelvic brim.