To investigate the clinical outcomes of closed reduction and internal fixation with percutaneous screws for crescent fracture-dislocation of the sacroiliac joint.

We reviewed 78 consecutive patients treated operatively for crescent fracture-dislocation of the sacroiliac joint from June 2003 to October 2014. They were 41 males and 37 females, with a mean age of 37.9 years (range, from 18 to 68 years). By Day classification, there were 18 cases of Type Ⅰ, 35 ones of Type Ⅱ, and 25 ones of Type Ⅲ. Closed reduction and percutaneous fixation was performed in 72 patients. For Type Ⅰ fractures, perpendicular to fracture line fixation was performed with 1-2 parallel iliac screws. For Type Ⅱ, crossed fixation was performed with 1-2 posterior iliac screws and 1-2 SIJ screws. For Type Ⅲ, fixation was performed with SIJ screws. Open reduction and internal fixation was performed in the 6 patients whose closed reduction failed.

Time for closed reduction and internal fixation for posterior crescent fracture-dislocation averaged 38 minutes in the 72 patients; their intraoperative blood loss was 23 mL; their incision length was 1.9 cm; their hospitalization time averaged 5.2 days. Of them, 70 were followed up for an average time of 14 months (from 6 to 24 months). By Matta scoring criteria, the reduction was excellent in 24 cases, good in 30, fair in 14, and poor in 2, giving an excellent to good rate of 77.1% . The average fracture healing time was 12.0 weeks. By Majeed system, functional outcome at the last follow-up was excellent in 34 cases, good in 26, fair in 8, and poor in 2, giving an excellent to good rate of 85.7% . No complications like redislocation, nonunion and implant failure occurred during the follow-ups.

Based on the Day classification, closed reduction and percutaneous screw fixation is an effective treatment for the majority of crescent fracture-dislocations of the sacroiliac joint.

Pelvis; Fractures, bone; Fracture fixation, internal; Surgical procedures, minimally invasive