Salvage Management of Anterior-Posterior Compression (APC) Type II Pelvic Ring Injury Using Isolated Posterior Fixation After Anterior Implant Removal: A Case Report.

Anterior-posterior compression (APC) injuries of the pelvic ring type II have been classically managed with anterior fixation, with or without posterior fixation. However, anterior approaches may be associated with wound complications, particularly in the setting of urologic or soft tissue injury. The role of isolated posterior fixation in this context remains unclear. We report a case of a 30-year-old male with an APC type II pelvic ring injury initially treated with combined anterior plating and posterior iliosacral screw fixation. The postoperative course was complicated by a deep surgical site infection at the anterior incision, necessitating implant removal and serial debridement. The posterior fixation was retained. Radiographic follow-up demonstrated maintenance of pelvic alignment, with anterior symphyseal diastasis stabilizing at 8 mm. Clinically, the patient achieved pain-free full weight-bearing by three months and returned to unrestricted ambulation at 11 weeks, with no evidence of instability. This case demonstrates that isolated posterior fixation may provide sufficient stability to allow functional recovery in selected APC type II injuries following anterior implant removal. This approach should be considered a salvage strategy rather than a primary treatment option. Further studies are required to define its indications.