A Comparative Study of Functional Outcomes in Unstable Pelvic Ring Fractures Treated With Internal Fixator (INFIX) With and Without Sacroiliac Joint Screw Fixation.

Abstract

Introduction Despite constituting only 3-8% of orthopedic trauma cases, pelvic injuries are associated with high mortality rates, emphasizing the critical need for stable fixation rather than merely anatomical alignment. The use of an anterior, subcutaneous, internal pelvic fixator (INFIX), a novel technique, has shown promise in treating these injuries. Posterior pelvic ring injuries are challenging because they require a significant level of surgical training and technical expertise, and each treatment method has disadvantages. The aim of this study is to compare the clinical and biomechanical outcomes of INFIX with and without sacroiliac screw fixation for unstable pelvic fractures. Methods and methodology Retrospectively, we selected 20 patients with unstable pelvic ring injuries who had come to a high-volume tertiary care hospital and medical college in the state of Maharashtra, India. All the patients were operated on with INFIX; 10 with a sacroiliac joint screw and 10 without a sacroiliac joint screw. We followed up with the patients for six months and evaluated them according to the Majeed score. Results Functional outcomesdiffered little between INFIX patients operated on with and without a sacroiliac joint screw. However, morbidity, hospital stay, the need for ICU, radiation exposure, and technical ease of surgery were improved in INFIX patients without the sacroiliac screw procedure. We noted an average Majeed score of 78 in the INFIX-alone group and 77.2 in the group that received INFIX with a sacroiliac joint screw. Six months after the surgery, the patients showed signs of a stable bony union, had achieved a full range of motion, and reported no problems in their day-to-day work. Conclusion Although this was a short-term study, we conclude that INFIX without a sacroiliac joint screw showed a comparable functional outcome compared to INFIX with a sacroiliac joint screw. Patients with INFIX alone showed better results; they had reduced surgical time, reduced radiation exposure, and less evidence of neurological harm to the L5-S1 nerve root. The procedure was less complicated and easier for surgeons to learn. Its simplicity and speed were especially beneficial for obese patients.