USAGE OF ANTERIOR SUBCUTANEOUS INTERNAL FIXATOR FOR TREATMENT OF PELVIC FRACTURES (INFIX): OUR EXPERIENCE

Abstract

Abstract Introduction Anterior subcutaneous internal fixator(INFIX) was proposed to treat anterior pelvic ring injury. INFIX was initially designed as an alternative to the external fixator, but recently its indications have been expanded, using it as a definitive treatment, and multiple complications have been reported. Methods Retrospective study of 11 polytrauma patients with pelvic fractures treated with anterior subcutaneous internal fixator after a high energy trauma between January (2018)-September (2021) Results 11 polytrauma patients. The average age was 50,5 years old. The mechanism of injury was precipitation, 5 run over and 2 vehicle accidents. According to Tile classification: type B:6 and type C:5, according to Young classification: lateral compression:3, anteroposterior compression:6 and vertical shear:2. The average time of implantation of INFIX was 4,3 days (0–17). In 10 cases a sacroiliac screw was associated at the same time of surgery and in one patient spinopelvic fixation. The patients sitting was allowed 24 hours after surgery and partial weight-bearing 6 weeks later. The average time until removal was 5 months and the average follow up was 10 months. Complications rate was 63,63%(n=7):3 Lateral femoral cutaneous nerve(LFCN) paresthesia:two of them temporary and another persistant one, 1 supracetabular screw osteolysis. 2 implant infections, 1 of them treated with implant removal and reosteosynthesis with symphysis plates. 1 common iliac vein thrombosis resolved with antithrombotic treatment. Conclusions Anterior subcutaneous internal fixator provides initial stability in pelvic fractures with a fast and simple technique. However, some complications have been reported. The main complication is LFCN paresthesia, especially during implantation and removal of the fixator.