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Iliac Wing: Fractures



- See: Sacro-Iliac Fracture Dislocations
- Management:
    - consider  direct frx fixation from iliac crest into sacrum;
    - under x-ray control, long, 6.5-mm cannulated lag screws transfix the frx from iliac wing to body of S-1;
    - because of risk to neural structures, K guide wire usually is inserted, and its position is confirmed before the screw is placed;
    - alternative approach with less potential for Neurologic Injury is to place fixation device between the two posterior iliac crests;
         - large diameter threaded sacral bars or double cobra plates are commonly employed.
- Incision:
    - incision is made parallel to the crest, allowing access to external and internal surfaces of the iliac wing.
    - depending on type of frx, long lag screws can be placed between two tables of the ilium, spanning the fracture site, or screws can be supplemented by plates