Clinical effect and complication of minimally invasive surgery in treatment of anterior and posterior pelvic ring injury

Abstract

Objective To evaluate the clinical effects and complications of sacroiliac screw instrumentation combined either with external fixation or anterior column screw fixation for treatment of posterior pelvic ring injury combined with fractures of anterior pubic and ischiadic ramus.Methods A retrospective review was conducted on 91 patients with posterior pelvic ring injury combined with fractures of anterior pubic and ischiadic ramus treated between December 2007 and December 2012.There were 67 males and 24 females aged at 22-61 years (mean,37.8 years).All together,51 out of the patients were treated with sacroiliac screws combined with external fixation and 40 underwent sacroiliac screw fixation combined with anterior screw fixation.Comparative analysis of the two surgical treatments were made in aspect of postoperative complications,postoperative ambulation time,fracture healing,Majeed pelvic function score,and visual analogue scale (VAS).Results Eighty-eight patients were available for the mean 13.6 months of follow-up (range,12-26 months).Except for postoperative complications and fracture healing,postoperative ambulation time [(31.0 ± 6.2) d vs (41.9 ± 7.2) d],excellence rate in Majeed pelvic function score (95％ vs 73％) and VAS score[(1.1 ± 1.3) points vs (3.5 ±2.0) points]were significantly better in patients treated with anterior column screw than in patients undergoing external fixation (P ＜ 0.05).Conclusion Sacroiliac screw combined with anterior column screw as an alternative to treat posterior pelvic ring injury combined with fractures of anterior pubic and ischiadic ramus advantages in early ambulation,relief of the pain,and few complications. Key words: Pelvis; Fracture fixation; Anterior column screws