Operative Management of Bilateral Symmetric Transverse Iliac Fractures

Bilateral and symmetric transverse fractures of the iliac wings are a rare fracture pattern having been described in only a few case studies. The mechanism of injury is thought to involve an acceleration‐deceleration trauma that causes an extreme hyperflexion force, which is transduced through the bilateral ilia resulting in a flexion‐distraction injury, comparable with Chance fractures of the spine. This mechanism and associated fracture pattern do not fit traditional systems of pelvic fracture classification and management. Previous case reports demonstrate success with nonoperative management of stable injuries; however, there is a paucity of literature describing operative management of these injuries. We present a case of a 63‐year‐old male who suffered symmetric, bilateral transverse iliac fractures as a restrained driver during a head‐on motor vehicle collision. He underwent subsequent operative management with bilateral screw fixation of the iliac wings through the LC‐2 corridor from a posterior approach with excellent radiographic and functional outcomes.