Crescent fractures of the pelvis is a sacroiliac joint
fracture dislocation. The fracture of the iliac wing enters the sacroiliac
joint. The fracture of the iliac wing enters the sacroiliac joint. There is a
varying degree of injury to the sacroiliac joint ligament (combination of iliac
fracture and sacroiliac joint disruption). The posterior ilium remains attached
to the sacrum by the posterior sacroiliac ligaments. The anterior ilium has an
internal rotational deformity. The posterior superior iliac spine remains
attached to the sacrum. This injury is known to be rotationally unstable;
however, some people believe it is more than that. Crescent fracture occurs by
a laterally directed force applied to the anterior part of the involved iliac
wing. There are three types of fractures based on the Young-Burgess
Classification. Type I is a small impacted fracture of the anterior sacrum.
Type II is a crescent fracture of the pelvis which is partially stable. Type
III is an unstable fracture type with ipsilateral lateral compression and
contralateral anteroposterior compression (windswept pelvis). CT scan defines
the posterior pelvic fracture adequately, and it also can define the crescent
fracture type. You can fix it by two screws from posterior to anterior, and you
can add a reconstruction plate on top of it. The whole idea is to achieve
anatomic reduction of the iliac wing, and the sacroiliac joint dislocation and
stable fixation. The fixation can be done by extra-articular internal fixation
using intertable lag screws and outer table neutralization plates. It can be
done through a posterior approach, and this will be fixing the iliac component.
The fixation can also be done percutaneously, and it also can be done with
screws through the sacroiliac joint.
