Bilateral Sacroiliac Joint Dislocation (Anterior and Posterior) With Triradiate Cartilage Injury: A Case Report

Lee, Dong Hoon; Jeong, Woong Kyo; Inna, Prashanth; Noh, Won; Lee, Dong Ki; Lee, Soon Hyuck

doi:10.1097/bot.0b013e31821148a8

Cited by 12 publications

(9 citation statements)

References 11 publications

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“…There is a lower incidence of combined injuries (e.g., pubic fractures) in children than in adults because of the greater plasticity of the children's pelvic bones and their thick periosteum, increased elasticity and flexibility of the symphysis pubis and sacroiliac joints, stronger ligaments, and increased capacity for energy absorption in the cartilaginous area. 1 , 2 , 3 , 4 It is not surprising, then, that anterior dislocation of the sacroiliac joint in adults is associated with more combined injuries, such as symphysis diastasis, iliac fracture, urethral injury, and occult vascular injury.…”

Section: Discussionmentioning

confidence: 99%

“…Several cases of anterior sacroiliac joint dislocations have occurred in children. 1 , 2 , 3 , 4 We present herein a case of anterior dislocation of the sacroiliac joint in an adult that was caused by severe violence. It was followed by complications, including an occult vascular injury after pelvic disruption that could have resulted in significant morbidity and even death.…”

Section: Introductionmentioning

confidence: 99%

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Occult external iliac vein injury after anterior dislocation of the sacroiliac joint in adult patient

Liu

Wang

Zhang

2017

Acta Orthopaedica et Traumatologica Turcica

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Anterior dislocation of the sacroiliac joint, characterized by dislocation of the ilium anterior to the sacrum, is a subtype of complete posterior pelvic ring disruption. This injury occurs mostly in children. We present an adult patient with anterior dislocation of the sacroiliac joint. It was associated with numerous complications. To the best of our knowledge, it is only the second case reported in the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Occult external iliac vein injury after anterior dislocation of the sacroiliac joint in adult patient

Liu

Wang

Zhang

2017

Acta Orthopaedica et Traumatologica Turcica

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“…Zhang et al described four cases: one patient was treated via open reduction with internal fixation, another was treated with closed reduction and percutaneous pins, and the remaining two were treated with closed reduction and traction alone 5 . Two additional pediatric cases required open reduction and treatment 6,7 .…”

Section: Review Of the Literaturementioning

confidence: 99%

“…T o the best of our knowledge, only four adult cases of pure anterior sacroiliac dislocation have been reported worldwide, with an additional six pediatric cases reported in recent years [1][2][3][4][5][6][7] . The few reported cases all describe patients with substantial concomitant injuries, resulting in major permanent disability.…”

Section: Review Of the Literaturementioning

confidence: 99%

Anterior Sacroiliac Dislocation

Shillito

Linn

Girard

et al. 2014

JBJS Case Connector

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I njuries to the sacroiliac joints are most commonly caused by high-energy trauma. Orthopaedic traumatologists frequently treat sacroiliac dislocations and fracture-dislocations as part of the spectrum of pelvic ring injuries. Typical sacroiliac joint dislocations are posterior; anterior dislocations are extremely rare. As with posterior dislocations, these are highenergy injuries with concomitant visceral, neurologic, and other osseous injuries. We describe a case of anterior sacroiliac dislocation that was treated with a closed reduction and percutaneous fixation in a trauma patient with multiple injuries.The patient was informed that data concerning the case would be submitted for publication, and she provided consent. Case ReportA twenty-one-year-old unrestrained driver was involved in a head-on collision with a tree at an unknown speed after reportedly attempting to avoid pedestrians in the road. She was initially evaluated in Mexico and was transferred to our level-I trauma center twelve hours after the accident.On admission to the trauma bay, the initial vital signs were blood pressure of 122/70 mm Hg, heart rate of 94 bpm, respiration of 24 bpm, and oxygen saturation of 100% on 2 L per nasal cannula. The initial hemoglobin and hematocrit levels were 10.9 g/dL and 31.6%, respectively. On examination, the patient was alert and oriented with a Glasgow Coma Scale score of 15. The spine was nontender, but she did have tenderness to palpation in the left sacroiliac region with accompanying ecchymosis posteriorly. The pelvis was unstable with lateral and anteroposterior compression.The patient had complete loss of sensation and motor function of the left lower extremity, although she had normal peripheral pulses in all four extremities. Perineal examination revealed no open wounds; however, there was left labial swelling and ecchymosis. A Foley catheter had been placed prior to arrival, and gross blood was identified in the urine. The stool guaiac test was negative, and there was minimally decreased rectal tone. There was a 5-cm laceration over the proximal part of the left tibia, a laceration on the posterior aspect of the right thigh, a 5-cm laceration overlying a fracture of the fifth metatarsal on the left foot, and multiple areas of tenderness and ecchymosis throughout the body.Initial radiographs and computed tomography (CT) scans demonstrated severe pelvic injuries, including a right posterior crescent fracture-dislocation, a left complete anterior sacroiliac joint dislocation, left superior and inferior pubic rami fractures, and L1-L5 transverse process fractures (Figs. 1-A through 1-D). Other orthopaedic injuries included a severely comminuted right tarsometatarsal fracture-dislocation, medial cuneiform and navicular fractures, a left type-2 open tibial plateau fracture, and a left type-2 open fracture-dislocation of the fifth metatarsal.Other than right-sided pulmonary contusions and a nonoperative extraperitoneal bladder rupture, the patient had no other noteworthy nonorthopaedic injuries, including b...

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“…The available internal fixation includes anterior plates, sacroiliac screws, or anterior plates combined with sacroiliac screws, in which sacroiliac screws associated with leverage or double plates fixation are ideal treatments. 1,10 The most widely used anterior approaches for exposing sacroiliac joint include the iliac fossa approach, the pararectus approach, and the lateral-rectus approach (LRA). However, the iliac fossa approach may cause the injury of vascular bundle and lateral femoral cutaneous nerve (LFCN).…”

Section: Introductionmentioning

confidence: 99%

Treatment of Anterior Dislocation of the Sacroiliac Joint via the Lateral‐rectus Approach: Surgical Techniques and Preliminary Outcomes

Fan

Chen

Mai

et al. 2023

Orthopaedic Surgery

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ObjectiveAnterior dislocation of the sacroiliac joint (ADSIJ) is caused by strong violence, and because of its low morbidity, there are no standardized diagnostic and therapeutical guidelines at this moment. This study aims to explore the surgical techniques and preliminary outcomes of the lateral‐rectus approach (LRA) for treating ADSIJ.MethodsA retrospective study was conducted of 15 patients with ADSIJ from January 2016 to January 2021. The patients' age ranged from 1.8 years old to 57 years old (37 ± 18 years old). All patients underwent open reduction and internal fixation (ORIF) through the LRA. Eight patients were combined with lumbosacral plexus injury and underwent neurolysis during operation. Patients' fracture type, mechanism of injury, associated injuries, operation time and intraoperative bleeding volume were accessed by reviewing medical history. Quality of fracture reduction was evaluated with the Matta score. At 1‐year follow‐up, the functional rehabilitation was evaluated by the Majeed rehabilitation criteria. For those with lumbosacral plexus injury, the neuromotor function was evaluated using muscle strength grading proposed by the British Medical Research Council (BMRC) and recovery was recorded.ResultsAll 15 patients underwent the operation successfully. The surgical time ranged from 70 to 220 min (126 ± 42 min), and the intraoperative blood loss ranged from 180 to 2000 mL (816 ± 560 mL). Eighty percent of the cohort (12/15) were rated as excellent and good in the Matta score for fracture reduction quality after operation without surgical incision‐related complications. At 1‐year follow‐up, the overall excellent and good rate was 73.3% (11/15) according to the Majeed criteria, the neuromotor function recovered completely in six cases and partially in two cases according to the BMRC muscle strength grading, and the recovery of sensory function was evaluated as excellent in six cases, good in one case and poor in one case, with an overall excellent and good rate of 87.5%.ConclusionThe LRA can well expose the surrounding structures of the sacroiliac joint from the front, which helps surgeons reduce and fix the anterior dislocation of the sacroiliac joint under direct vision and effectively decompress the entrapment of the lumbosacral plexus to achieve better clinical efficacy.

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Bilateral Sacroiliac Joint Dislocation (Anterior and Posterior) With Triradiate Cartilage Injury: A Case Report

Cited by 12 publications

References 11 publications

Occult external iliac vein injury after anterior dislocation of the sacroiliac joint in adult patient

Occult external iliac vein injury after anterior dislocation of the sacroiliac joint in adult patient

Anterior Sacroiliac Dislocation

Treatment of Anterior Dislocation of the Sacroiliac Joint via the Lateral‐rectus Approach: Surgical Techniques and Preliminary Outcomes

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