When fixation of the sacro-iliac joint is necessary, the patient is often in a critically injured state. Presently either cannulated screws are inserted under radiological control or plating is used. These techniques have drawbacks: the time-consuming cannulated screw technique is not always ideal in the polytraumatised patient, and fixation of plates generally calls for entry into non-injured areas. Since 1999 the author has used the USSC spinal system to stabilise the sacro-iliac joint in four patients. The technique does not involve entry into non-injured tissues, and provides enough stability to mobilise the patient immediately.
In a prospective study of 132 patients with an average age of 35 years, unstable intra-articular fractures of the distal radius were treated by external fixator. Only 15 cases required limited open reduction. Follow-up was for a mean of 42 months. There were few complications and 83% of patients had good or excellent results. There was a statistically significant correlation between the severity of the fracture and the clinical outcome, irrespective of radiological restoration. Articular and soft-tissue damage following violent compressive forces may lead to a degree of functional impairment.
