Percutaneous reduction of LC-2 pelvic ring fracture

Volume 56, Issue 12, December 2025, 112811

Author links open overlay panel, , , , , AbstractMinimally invasive reduction of lateral compression type 2 (LC-2) pelvic ring fractures is not well described [1]. While the gold standard remains open reduction and internal fixation with plates and screws, this technique is associated with notable risks, including significant blood loss, nerve injury, wound dehiscence, and postoperative infection [[1], [2], [3]].

A minimally invasive technique of fracture reduction and fixation for LC-2 fractures is presented, with emphasis on imaging to visualize realignment of the reduced ilium.

Introduction

Pelvic ring fractures are rare, sometimes lethal, orthopedic injuries. When surgical intervention is indicated, open reduction and internal fixation (ORIF) is widely regarded as the preferred approach [3,4]. However, this strategy carries risks of substantial blood loss, nerve injury, infection, and urological injuries [[4], [5], [6]].

Percutaneous fixation of pelvic ring fractures is a valid treatment option [[7], [8], [9]]. This approach offers clear advantages including reduced blood loss, fewer wound complications, low infection rate and a generally low overall complication rate [10]. Nonetheless, the techniques for achieving proper reduction are not well described in the literature.

This paper aims to describe percutaneous reduction techniques for LC-2 pelvic fractures. The surgical sequence is detailed, and the fluoroscopic imaging techniques used to guide reduction and screw placement are illustrated.

Section snippetsPreoperative planning

Indications for percutaneous LC-2 fracture fixation are the same as those for the open approach. Patients should be taken to the operating room as early as appropriate to facilitate easier percutaneous reduction of the fracture.

A preoperative CT scan provides a clearer understanding of the size of the crescent fracture and the displacement of the mobile portion of the iliac wing. Displacement can be evaluated on axial cuts through the disrupted sacroiliac joint to assess both anteroposterior

Discussion

This paper presents a technical guide for minimally invasive reduction and percutaneous fixation of LC-2 type pelvic ring fractures. In our experience, the displaced portion of the ilium can be effectively reduced and stabilized with percutaneous LC-2 corridor screws.

Clinical studies describing percutaneous pelvic fracture fixation have shown promising results [10,13]. However, to date, reduction methods for LC-2 fractures have not been well described in peer reviewed literature. Previous

Conclusions

Percutaneous screw fixation of LC-2 pelvic ring fractures allows for stable anatomical reconstruction of the pelvic ring while minimizing soft tissue injury and surgical complications. This technical guide provides a step-by-step description of the procedure to assist surgeons considering the adoption of this technique.

Ethics statement

No identifiable information is presented, and all images have been anonymized in accordance with ethical publishing standards. As this is a technical note paper, formal ethics committee approval was not required.

CRediT authorship contribution statement

Alona Katzir: Data curation, Methodology, Visualization, Writing – original draft, Writing – review & editing. Matthew Morones: Data curation, Validation. Taylor C. Kot: Data curation, Validation. Ishvinder S. Grewal: Supervision, Validation. Ashoke K. Sathy: Supervision, Validation. Adam J. Starr: Conceptualization, Methodology, Resources, Supervision, Validation, Writing – review & editing.

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Adam J Star reports a relationship with Starr Frame LLC that includes: equity or stocks. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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