Artikel
Minimally invasive internal fixator for unstable pelvic ring injuries with a pedicle screw-rod system: a retrospective study of 23 patients
Suche in Medline nach
Autoren
-
Shuang G Yan
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
-
Xingyi Hua
- The First Affiliated Hospital of Anhui Medical University, Department of Orthopaedic Surgery, Hefei, China
-
Yiliang Cui
- The First Affiliated Hospital of Anhui Medical University, Department of Orthopaedic Surgery, Hefei, China
-
Zongsheng Yin
- The First Affiliated Hospital of Anhui Medical University, Department of Orthopaedic Surgery, Hefei, China
-
Anna Janine Schreiner
- BG Unfallklinik, Univ. Tübingen, Tübingen , Germany
-
Florian Schmidutz
- BG Unfallklinik, Univ. Tübingen, Tübingen , Germany
| Veröffentlicht: | 6. November 2018 |
|---|
Gliederung
Text
Objectives: Pelvic ring fractures are highly challenging injuries and require effective treatment. The purpose of this study was to evaluate the clinical and radiological outcome of unstable pelvic ring injuries treated with a relatively novel technique using the minimally invasive pedicle screw-rod system.
Methods: A case series of unstable pelvic ring injuries treated with an anterior internal pelvic fixator (INFIX) with or without posterior pedicle screw-rod fixator was assessed. The hospital database was retrospectively screened between June 2012 to April 2015 and patients included with a trauma treated with an anterior INFIX with or without a posterior fixation.
Evaluation included the operation time, intraoperative blood loss and complication rate. The quality of reduction was evaluated by the established Tornetta and Matta criteria and the clinical outcome was assessed by the Majeed scores.
Results and conclusion: The collective compromised 23 patients (12 males, 11 females) with a mean age of 37.6 years (range, 10-55) and a mean follow-up of 13.5 months (range, 6-27 months). The Tile classification showed 13 type B fractures (6 type B1, 4 type B2, and 3 type B3) and 10 type C fractures (7 type C1, 3 type C2). Mean operation time and intraoperative blood loss volume was 24.8 min (range, 20-30 min) and 20.4 ml (range, 16-29 ml) for patients receiving an anterior INFIX (n=13) and 60 min (range, 45-70 min) and 150 ml (range, 115-168 ml) when an INFIX with posterior pedicle screw-rod fixator (n=10) was required. The quality of fracture reduction was excellent in 13, good in 6 and fair in 4 patients, with no signs of heterotopic ossification. Clinical results 6 months postoperatively were excellent in 14 patients, good in 6, fair in 2, and poor in 1. Two patients sustained unilateral anterolateral thigh paresthesia which resolved after anterior implant removal.
The INFIX appears to be a safe and minimally invasive surgical technique which can effectively be combined with posterior pedicle screw-rod fixation. It also can be applied for the definitive treatment of vertically and/or rotationally unstable pelvic ring injuries, especially in severely compromised patients with a high mortality risk.
Figure 1 [Fig. 1]
