The anterior sacroiliac ligament is a thin but broad reinforcement of the anterior SIJ capsule, covering the anterior joint margin from the iliac fossa to the sacral ala, weaker than the posterior ligamentous complex.
Provides the anterior capsular reinforcement of the SIJ, resists anterior sacral rotation (nutation) and anterior joint gapping, and is the first structure disrupted in anterior SIJ instability from pelvic ring injury.
The anterior SIJ ligament is less strong than the posterior interosseous ligament but important in determining SIJ stability patterns. Open reduction of SIJ dislocation requires identification of the anterior ligament remnants for reduction guidance. Anterior SIJ plating provides the anterior column fixation supplementing posterior screw fixation.
Anterior sacroiliac ligament disruption in vertical shear pelvic injuries producing SIJ instability requiring both anterior plate and posterior screw fixation for stability.
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