Comparison of percutaneous cross screw fixation versus open reduction and internal fixation for pelvic Day type II crescent fracture-dislocation: case-control study

Guangheng Xiang,Jian Xiao,Xiaoshan Guo,Jianshun Wang,Leyi Cai,Yongzeng Feng,Xiaoyu Dong,Xingan Jiang

doi:10.1186/s13018-020-02197-1

Abstract

ObjectiveTo investigate the clinical outcomes of percutaneous cross screws internal fixation for pelvic Day type II crescent fracture-dislocation.MethodsWe reviewed 66 consecutive patients undergoing surgical treatment for Day type II crescent fracture-dislocation from June 2005 to December 2017. Percutaneous cross screws internal fixation was performed in 40 patients, and open reduction and internal fixation was performed in 26 patients. The patient characteristics, surgical complications, radiographic and clinical outcomes and were compared.ResultsThere was no statistically difference on the mean time from injury to surgery between the two groups. The time of operation, the amount of blood loss, the length of incision, and the hospital stay were significantly shorter in the percutaneous cross screws internal fixation group. No significant difference on Matta scores and Majeed scores between the two groups. The open reduction and internal fixation group resulted in a higher rate of intraoperative hemorrhage, nerve injury, discomfort, and pain.ConclusionPercutaneous cross screws internal fixation for Day II type pelvic crescent fracture-dislocation was safe and effective. Minimally invasive fixation had the advantages of short operation and hospitalization time, less intraoperative bleeding, and surgical trauma.

Highlights

Pelvic fractures are often caused by high-energy injuries, often accompanied by abdominal organs, blood vessels, nerve injuries, and with many complications and high mortality [1,2,3,4]
We have proved that percutaneous cross screw fixation was a reliable method for the treatment of Day type II crescent fracturedislocation (CFD) through a finite element analysis [13]
According to different surgical methods, patients with Day type II CFD were divided into minimally invasive percutaneous cross screw internal fixation treatment group and open reduction and internal fixation treatment group

Summary

Introduction

Pelvic fractures are often caused by high-energy injuries, often accompanied by abdominal organs, blood vessels, nerve injuries, and with many complications and high mortality [1,2,3,4]. Once the pelvic fracture affects the integrity of ligaments and muscle structures, the stability of the sacroiliac joint will be destroyed, causing the posterior ring of the pelvis to become unstable [5]. Pelvic crescent fracture and dislocation were first reported by Borrelli et al in 1996 [6, 7]. It was a sacroiliac joint complex injury, and the fracture of the iliac bone extended from the sacroiliac joint site upwards to the iliac crest, with a partial dislocation of the anterior sacroiliac joint. For the treatment of type II fractures, it was usually carried out by anterior or posterior approach open reduction and internal fixation (ORIF) [9,10,11]. There was still some controversy about the surgical trauma and internal fixation methods [12]

Methods

Results

Discussion

Conclusion