Modified internal fixator for anterior pelvic ring fractures versus conventional two-screw fixation.

Abstract

The present study aims to evaluate the short-term clinical effects and complications of modified three-screw fixation and conventional two-screw fixation for treating anterior pelvic ring fractures. A retrospective study of 51 patients with type B fractures was performed. 25 patients (modified group) were treated with modified three-screw fixation and the other 26 patients (conventional group) with conventional two-screw fixation. Outcome measures included operation time, intraoperative blood loss, hospital stays, postoperative complications and the Majeed score at postoperatively 2months, 3months, 1year and the time of implant removal. The mean operative times and mean blood loss for modified three-screw fixation versus conventional two-screw fixation bilateral were 54.8 ± 10.7min versus 32.3 ± 9.9min, and 153.3mL versus 550.0mL (p < 0.001), respectively. However, the Majeed score was better in modified group at postoperatively 2months (75.6 ± 9.5 vs. 69.7 ± 8.3, p = 0.008) and 3months (80.3 ± 10.7 vs. 75.1 ± 11.9, p = 0.014). There was no statistical difference between two groups at the time of implant removal (82.1 ± 9.3 vs. 80.9 ± 8.8, p = 0.272) and postoperatively 1year (83.5 ± 7.8 vs 82.6 ± 8.2, p = 0.723). No patients experienced surgical wound infection, deep vein thrombosis, delayed union or nonunion, implant loosening or rupture. One patient complained of tardive unilateral thigh pain at postoperatively 4months in conventional group. Both modified three-screw fixation and conventional two-screw fixation could ultimately afford satisfactory clinical and radiological outcomes with less complication for anterior pelvic ring fractures. The modified three-screw fixation might have better biomechanical strength and faster pelvic rehabilitation.