The clinical efficacy of 3D image-guided minimally invasive screw fixation in the treatment of Tilt pelvic fracture in middle-aged and elderly patients

Abstract

Objective To evaluate the clinical efficacy of 3D image-guided minimally invasive screw internal fixation in the treatment of Tilt pelvic fracture in middle-aged and elderly (45-74years) patients. Methods A retrospective analysis including 35 middle-aged and elderly patients with Tilt pelvic fracture treated with the minimally invasive screw internal fixation was done from June 2015 to January 2017. Fifteen males (42.9%) and 20 females (57.1%). The age range was 45 to 73 years with an average of (56.4±3.7) years. According to the Tile classification: 23 cases was B2.1 type, 9 cases was B2.2 type and 3 B3 type. The posterior pelvic ring injuries had 23 DenisⅠtype, and 12 DenisⅡtype. The operative incision, blood loss during insert screw, time of operation, reduction quality, Majeed pelvic fractures function scores at the last follow-up and postoperative complications were recorded to evaluate its clinical effect. Results All patients had follow-up for an average of (6.9±1.9) months, range from 3 to 12 months. Length of incision was (2.7±1.5) cm, range from 1 to 4 cm. The time of each screw insertion was (29.4±1.7) min, range from 20 to38 min. Blood loss for screw insertion was too small to count. The quality of anterior pelvic ring fractures reduction were evaluated according to Matta standardization, 27 cases were excellent, 4 cases were good and 4 moderate, rate of excellent to good reduction was 88.6%. The quality of posterior pelvic ring fractures reduction were 27 excellent, 5 good and 3 moderate, the excellent to good rate of reduction was 91.4 %. The Majeed standardization showed 23 cases were excellent, 6 cases were good and 6 cases were moderate, the excellent to good rate of healing was 82.9%. There were no pain, wound infection, nerve injury, heterotopic ossification, thrombosis complications occurred. Conclusion The 3D image-guided minimally invasive screw internal fixation is a precise, safe, less trauma and low complications for middle-aged and elderly patients with Tilt pelvic fractures, it is a possible ideal method for clinics. Key words: Pelvis; Fractures; Minimally invasive surgical procedures; Surgery, computer-assisted; 3D printing