Abstract
BackgroundAnterior pelvic ring fracture, as high-energy trauma, needs to be effectively treated. The purpose of the current study was to evaluate the clinical applications of modified pedicle screw-rod fixation and anterior pelvic external fixation for the treatment of anterior pelvic ring fracture.MethodsEither modified pedicle screw-rod fixation (modified PSRF group, N = 21) or anterior pelvic external fixation (APEF group, N = 22) was performed to 43 patients, with or without fixation of posterior ring. Clinical outcomes were evaluated via Majeed scores. Relevant clinical evaluation indicators including operation time, intraoperative blood loss, hospitalization duration, and complications were compared between these two groups.ResultsThe operation time in APEF group was significantly less than that in modified PSRF group (P < 0.0001). No significant difference with respect to intraoperative blood loss and hospitalization duration between the two groups was shown (P = 0.51 and P = 0.33, respectively). Six patients developed surgical site infection in APEF group. Three patients experienced loss of fixation, and two patients experienced loosening of fixator in APEF group. Temporary lateral femoral cutaneous nerve irritation occurred in three patients in modified PSRF group while two patients in APEF group. One patient experienced femoral nerve palsy in modified PSRF group. Fractures of all patients healed well eventually. No statistical difference regarding Majeed evaluation scores was found between two groups.ConclusionsApplication of both modified PSRF and APEF could provide similar satisfactory clinical outcomes for anterior pelvic ring fracture. Modified PSRF, a minimally invasive technique with the advantages of internal fixation, could be performed as an alternative method for instable pelvic fractures.Trial registrationResearch Registry UIN: researchregistry2776.
Highlights
Anterior pelvic ring fracture, as high-energy trauma, needs to be effectively treated
While a variety of treating methods have been employed, successful management of unstable pelvic fractures remains a challenge to orthopedic surgeons [2]
We modified this technique in clinical practice by adding another pedicle screw in the region of pubis, defined as modified pedicle screw-rod fixation, to improve the fixation strength
Summary
As high-energy trauma, needs to be effectively treated. The purpose of the current study was to evaluate the clinical applications of modified pedicle screw-rod fixation and anterior pelvic external fixation for the treatment of anterior pelvic ring fracture. A novel method of these techniques is to perform two pedicle screws fixed into the ilium and use a curved rod for connection [14, 15]. We modified this technique in clinical practice by adding another pedicle screw in the region of pubis, defined as modified pedicle screw-rod fixation (modified PSRF), to improve the fixation strength. The current study aims to evaluate the clinical effects of modified PSRF and APEF for treating unstable anterior pelvic ring fractures. All procedures were performed in the light of the Declaration of Helsinki
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