Open versus percutaneous fixation of unstable posterior pelvic ring injuries

Abstract

Objective This is a prospective clinical study on 40 patients with unstable posterior pelvic ring injuries to compare percutaneous fixation technique with open fixation technique. Background Unstable pelvic ring fractures are usually secondary to high-energy trauma and usually associated with high mortality and morbidity. There are several surgical approaches to the treatment of unstable posterior pelvic ring injury: open or percutaneous screw fixation and plate fixation of posterior pelvic ring injury, each having respective advantages and disadvantages. Patients and methods Two techniques have been used for the fixation of the posterior pelvis, each with advantages and disadvantages specific to the technique. A total of 40 cases of completely unstable pelvic ring injuries type C were managed by either percutaneous techniques (group I included 20 patients) or open reduction and internal fixation (group II included 20 patients). Anatomical reduction and restoration of the length of limb were the main aim during the surgery. Results The data were analyzed as follows. Tile classification, radiological evaluation according to maximal residual displacement at final follow-up, and functional evaluation according to Lindhal scoring system. Forty patients were included, with 31 male and nine female patients. Overall, 11 patients had excellent results, 20 patients had good, eight patients had fair, and one patient had poor. Conclusion Percutaneous fixation of unstable posterior pelvic ring injuries shows better results and fewer complications in comparison with open technique of fixation.