Minimally invasive posterior reconstructive plating by parallel Kirschner wires for unstable posterior pelvic fractures

Abstract

Objective To explore the clinical efficacy of minimally invasive posterior reconstructive plating by parallel Kirschner wires in the treatment of unstable posterior pelvic fractures. Methods From January 2013 to December 2016, 29 patients with unstable posterior pelvic fracture were treated at Trauma Center, Liuzhou Workers＇ Hospital. They were 22 men and 7 women, aged from 19 to 65 years (mean, 44.2 years). By the Tile classification, 10 cases were classified as type B and 19 as type C. The delay from injury to surgery ranged from 4 to 14 days (mean, 8.7 days). All the patients received minimally invasive posterior fixation with a U-shaped reconstructive plate and parallel Kirschner wires. The length of incision, intraoperative bleeding, operation time, quality of fracture reduction, curative effects and complications at the last follow-up were recorded. Results The length of intraoperative unilateral incision ranged from 2.3 to 3.4 cm (average, 2.99 cm); the volume of intraoperative bleeding ranged from 47 to 88 mL (average, 69.9 mL); the average operation time ranged from 17 to 34 min (average, 25.2 min). One patient was lost to the follow-up. The other 28 patients were followed up for 14 to 26 months (average, 18.3 months). The fracture healing time ranged from 8 to 15 months (average, 10.1 months). According to the Matta criteria for fracture reduction, 17 cases were rated as excellent at the last follow-up, 9 as good, one as fair and one as poor, giving an excellent to good rate of 92.9%. According to the Pohlemann functional scoring, 14 cases were rated as excellent, 11 as good, 2 as fair and one as poor, giving an excellent to good rate of 89.3%. Conclusion In the treatment of unstable posterior pelvic fractures, minimally invasive posterior reconstructive plating by parallel Kirschner wires presents advantages of high security, limited surgical trauma, good curative effects and limited postoperative complications. Key words: Pelvis; Fractures, bone; Fracture fixation, internal; Bone plates; Kirschner wires