INFIX-safe and effective surgical option for complex fracture patterns of the anterior pelvic ring: A prospective single center study

Abstract

BackgroundComplex fracture patterns of anterior pelvic ring are a challenge and usually needs extensive surgeries. The purpose of this study was to evaluate INFIX as a minimally invasive procedure for such injuries in terms of feasibility, outcomes and complications in the Indian population. MethodsPatients with complex fracture patterns of anterior pelvic ring were selected for anterior INFIX application along with standard posterior stabilization. Outcomes were assessed radiographically by Matta's criteria and amount of displacement. Post-operative CT scan for relation of implant to vital structures and Doppler at varying hip flexion for possible vascular occlusion was used. Functional outcomes included both disease specific scores (Majeed score, IOWA pelvic score) and quality of life scores (SMFA, SF-12). Complications were also noted. Results12 cases out of 112 patients had complex fracture pattern of the anterior ring. Most common injury pattern were LC-3 and VS (n = 6 and 3) Young and Burgess type. The average follow up was 6 months. Fracture reduction as per Matta's criteria was excellent in 10 (83.3%) cases and good in 2 (16.6%) cases with functional outcomes excellent in 11 cases, and a mean Majeed score of 92.67 ± 5.8. The average SMFA score was 51 ± 4.39 and mean SF-12 scores for physical and mental health were 48.493 ± 6.74 and 56.370 ± 4.04 respectively. Complications noted were lateral femoral cutaneous nerve palsy (1/24 nerves), skin dehiscence (n = 2), infection (n = 2) and sacral nonunion (n = 1). ConclusionINFIX is a safe and effective minimally invasive technique for addressing complexfracture patterns involving the anterior half of pelvic ring with excellent fracture reduction, radiological and functional outcomes and predictable fracture healing.