Evaluation of the early radiological and functional results of percutaneous fixation of unstable pelvic ring injuries

Abstract

Recent years have seen improvements in all phases of pelvic fracture management. The surgical treatment of pelvic ring injuries is technically demanding The aim of treatment is to achieve anatomical or near anatomical restoration of the articular surface, accurate reduction of the pelvic ring in mechanically unstable injuries, reduce pain, allows early mobilization of the patient and optimizes long term functional results This study aimed to evaluate the early radiological and functional results of percutaneous fixation of unstable pelvic ring injuries. From October 2019 till December 2020 twenty patients (11male and 9 female) with unstable pelvic ring injuries were included in the study. The mean age 42 years (range 18–66 years). The most common mode of injury was road traffic accident (RTA) followed by fall from height. The most common injury pattern according to Young and Burgess lateral compression injury, anteroposterior compression injury and vertically unstable. Four patients had medical comorbidities diabetes mellitus and hypertension at presentation. All patients treated by DCO protocol. 3 patients with posterior pelvic ring injuries treated by percutaneous iliosacral screw. 3 patients with anterior pelvic ring injuries treated by external fixator. 2 patient with anterior pelvic ring injuries treated by INFIX .8 patients with anterior and posterior pelvic ring injuries treated by external fixator and percutaneous iliosacral screw.1 patients with anterior and posterior pelvic ring injuries treated by INFIX and percutaneous iliosacral screw.2patients with anterior pelvic ring and posterior pelvic ring injuries treated by INFIX and spinopelvic fixation.1 patients with anterior pelvic ring and posterior pelvic ring injuries treated by external fixator and spinopelvic fixation. The mean injury-to-surgery interval was 6.1 days (range 0-12 days). The mean intraoperative blood loss 160ml range 100ml -240 ml. Percutaneous fixation of pelvic ring injuries offers safe, short operative time technique, less complication, with better results, short hospital stay, early healing and should be the standard way for pelvic ring fractures fixation. High quality pre-operative and intra-operative imaging, image-guidance, are essential for an equally high quality of surgical results.