The study retrospectively determined the efficacy and safety of fixation of the pelvis (FFP) fragility fractures type IV using two tension band ilioiliac locking compression plates. Forty-one patients with FFP were treated in 2017–2020. 16 patients with FFP type IV, unable to walk weight-bearing, were treated by fixation using two tension band ilioiliac locking compression plates without fixing the anterior ring. Preoperatively and one year postoperatively, the functional outcome and performance were assessed using Pelvic Discomfort Index (PDI) and Timed Up and Go (TUG) test. Pre- and postoperative hemoglobin level was evaluated. Operation time and intra-and postoperative complications were documented. One year postoperatively, an X-ray was taken. The arithmetic mean (x) and standard deviations (±) of quantitative variables were calculated. T-test for dependent samples was used for pre-and postoperative results comparison. The PDI improved (p < 0.001) from x = 81.42 ± 4.04 to x = 36.19 ± 15.58. Preoperatively none of the patients was able to perform the TUG test. Postoperatively, the result exceeded x = 13.13 ± 3.99 s. The operation lasted x = 42.80 ± 8.90 min. Hemoglobin decreased (p < 0.001) from 11.63 ± 1.11 to 9.07 ± 1.21 g/dL. No complications nor fixation loosening were noted. The study support fixation using two tension band ilioiliac locking compression plates as an efficient and safe treatment of the FFP type IV.

The standard starting point for the percutaneous sacroiliac screw insertion defined by Matta and Saucedo was initially determined for surgeries performed in a prone position. Still, the technique has also been used in surgeries performed in a supine position. Therefore, the cadaveric study aimed to determine the best entry point for the percutaneous insertion of sacroiliac screws depending on the patient's positioning for surgery. K-wires were percutaneously inserted into the sacral body of eight human cadavers. In addition to the standard sacroiliac screw entry point, points located 1 cm and 2 cm cranially from along the line, prolonging the femoral axis, were studied. The K-wires were inserted into the studied entry points on the right side in a supine position and on the left side of the same cadaver in a prone position. The placement of the K-wires was assessed using radiographic imaging and cadaver dissection. The analysis revealed that all three studied entry points enabled the correct placement of orthopedic implants for surgery in the prone position. In turn, for surgery performed in the supine position, the best entry point was located 2 cm cranially from the standard entry point, along the line prolonging the femoral axis.

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Introduction. The most challenging injury in orthopedic surgery is pelvic trauma. There are different concepts of treatment strategies, specially in final treatment of pelvic ring and acetabular fractures. Objectives. Analysis of recent studies and evaluation of treatment methods. Materials and Methods. Analysis of 22 recent studies. Five papers met our inclusion criteria, that equated 745 patients. Results. Patients hemodynamically unstable need to be resuscitated and „damage control” orthopedics is widely accepted method. Definitive treatment after fourth day should be performed. Some papers show that early, within 48 hours, definitive treatment of pelvic ring and acetabular fractures give similar or better results. Conclusions. Tendency to early definitive treatment is widely observed and decreases mortality rates and complications.