Minimally Invasive Fixation for Spinopelvic Dissociation: Percutaneous Triangular Osteosynthesis with S2 Alar-Iliac and Iliosacral Screws

CASE: Traumatic U- and H-type sacral fractures are often unstable, causing spinopelvic dissociation. We describe a minimally invasive approach that allows percutaneous spinopelvic fixation of unstable H-type sacral fractures using a triangular osteosynthesis construct with S2 alar-iliac screws. We present the case of a patient with traumatic lumbopelvic dissociation who underwent percutaneous S2 alar-iliac and iliosacral screw fixation. CONCLUSIONS: Combined percutaneous S2 alar-iliac and iliosacral screw fixation is a safe option for spinopelvic fixation and avoids the soft-tissue compromise of open approaches. The triangular osteosynthesis construct provides adequate pelvic anchor points to allow immediate weight-bearing.