Reduction and fixation of sacroiliac joint dislocation by the combined use of S1 pedicle screws and the galveston technique

STUDY DESIGN: This retrospective study was designed to analyze the results of the treatment with S1 pedicle screws and the Galveston technique of seven patients with sacroiliac dislocation. OBJECTIVES: To evaluate the effectiveness of the combined use of S1 pedicle screws and the Galveston technique for the treatment of sacroiliac dislocation. SUMMARY OF BACKGROUND DATA: Although several procedures for internal fixation of sacroiliac dislocation have been reported, there have been no reports discussing surgical treatment of sacroiliac dislocation by the combined use of S1 pedicle screws and the Galveston technique. METHODS: Seven patients with sacroiliac dislocation were treated with pedicle screws of S1 and iliac rod according to the Galveston technique. In the seven patients, the dislocation was associated with vertical displacement of the sacroiliac joint and rotational deformity of the pelvic ring. They were classified into Type-C pelvic disruption according to the Tile's classification. Three patients with disruption of the symphysis pubis underwent additional fixation of the symphysis using a dynamic compression plate. The remaining four patients were treated by the posterior procedure alone. RESULTS: The vertical displacement was completely reduced in five patients, and the rotational deformity was completely corrected in four patients. The reduction was maintained at the time of the final follow-up evaluation. There were no perioperative complications with the exception of late infection in one patient. CONCLUSIONS: The combined use of S1 pedicle screws and the Galveston technique provided immediate stability and sufficient reduction for sacroiliac dislocation in seven patients in this study. This hybrid internal fixation procedure is useful for reduction and fixation of sacroiliac dislocation associated with the vertical and rotational instability of the pelvic ring.