Anterior subcutaneous internal fixation with triple pedicle screws for treatment of Tile type B pelvic fractures

Abstract

Objective To evaluate the clinical outcome of anterior subcutaneous internal fixator (ASIF) system with triple pedicle screws in stabilizing Tile type B pelvic fractures. Methods From August 2013 to April 2015, 38 cases of pelvic fractures were stabilized with the ASIF system using triple pedicle screws. There were 24 male and 14 female cases, with the age range of 16-74 years [(41.5±5.5)years]. Causes of injury were traffic accidents (n=28), crushing injury (n=6) and fall from height (n=4). All cases had Tile type B fractures, including 5 cases of type B1, 29 type B2 and 4 type B3. Intraoperative blood loss, operation time, length of hospitalization and complications were detected. Postoperative function evaluation was done using the Majeed score. Results All cases were available for follow-up of 6.5-13.5 months (mean, 10.5 months). Intraoperative blood loss was (30.8±7.1)ml, operation time was (51.5±9.2)minutes, and length of hospitalization was (5.0±3.1)days. Among them, 34 cases showed bilateral hip flexion over 95 degrees after operation, and 24 cases were able to squat fully 1.5 months after operation. No cases experienced nonunion, delayed union, superficial or deep surgical wound infection, urethral injury and dysuresia. Two cases developed temporary lateral femoral cutaneous nerve numbness. According to the Majeed score, excellent results were found in 32 cases (84%) and good results in 6 cases (16%). Conclusion ASIF system with triple pedicle screws results in high healing rate and few complications in the treatment of Tile type B pelvic fractures, and hence deserves popularization in clinic. Key words: Pelvis; Fracture fixation; Surgical procedures, minimally invasive