ABSTRACT
The sacroiliac articulation is one of the most complex joints orthopedic surgeons deal
with. The anatomy of the sacrum and surrounding structures make diagnosis and fix-
ation difficult. Recognition of these injuries was difficult before the advent of roentgen-
ograms. Until recent times, these injuries were treated conservatively, with no surgical
intervention. Most pelvic injuries are stable, meaning they will not displace significantly
when faced with physiologic loads (1). For the unstable injuries, conservative manage-
ment results in deformity, leg length discrepancy, chronic pain, and occasionally non-
union (2). Attempts at closed reduction with traction and manipulation are often
unsuccessful due to the strong deforming forces the posterior ring is subjected to. Early
reports of persistent back pain and leg discomfort with conservative treatment led sur-
geons to become more aggressive with sacral injuries (3,4).
