An unstable pelvic ring disruption (Tile C1 vertical shear injury) is being managed operatively. Which fixation method best controls the posterior ring?

• A Anterior external fixator in iliac crests alone
• B Iliosacral screws (sacroiliac screws) percutaneously placed under fluoroscopic guidance ✓
• C Pubic symphysis plate alone
• D Sacral bar fixation (transiliac rod)

Explanation

Tile C injuries involve complete disruption of the posterior sacroiliac complex; the posterior ring provides 60% of pelvic stability. Percutaneous iliosacral screw fixation — inserted through the posterior superior iliac spine into the S1 or S2 sacral body under fluoroscopic (inlet, outlet, lateral) guidance — provides the most reliable posterior ring stabilisation with low soft-tissue morbidity. External fixators and symphysis plating control the anterior ring only and are insufficient alone for vertically unstable injuries.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.