Abstract
Introduction
To evaluate the clinical outcomes of anterior subcutaneous internal fixator using triple pedicle screws (ASIF/TPS) in the treatment of unstable type B pelvic fracture compared with open reduction internal fixation (ORIF).
Materials and methods
This was a retrospective cohort study of 26 patients with type B unstable fractures that underwent ASIF/TPS and 26 similar patients that underwent ORIF using plates and screws. Intraoperative blood loss, operating time, and post operation hospitalization duration were compared. Anteroposterior, inlet, and outlet X-rays and 3D computed tomography were obtained. Pain, numbness, sexual dysfunction, and activity were evaluated at every follow-up visit until the implants were removed. The Majeed score was used to assess the clinical and radiological outcomes.
Results
Blood loss, operating time, and hospitalization duration were less (all P < 0.001) in the ASIF/TPS group compared with the ORIF group. The clinical and radiological outcomes of the ASIF/TPS group after a mean follow-up of 6 months were excellent and good in 80.8%, and moderate in 19.2%. In comparison, the results of the ORIF group were excellent and good in 65.4%, moderate in 29.0%, and poor in 5.6%. No patient experienced nonunion, delayed union, superficial infection, or deep surgical wound infection. No urethral injury or dysuria occurred in the ASIF/TPS group. Two patients had temporary lateral femoral cutaneous nerve numbness after operation. There were two superficial wound infections in the ORIF group.
Conclusions
The use of ASIF/TPS with triple pedicle screws could be a reasonable option for the treatment of type B unstable pelvic fractures.
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Acknowledgements
We thank Yilin Zhou for the 3D drawings. This work was financially supported by the Department of Major Projects of the Shanghai Science and Technology Committee Foundation (Grant No. 11JC1410400), the Shanghai Health System Important Disease Joint Research Project (Grant No. 2013 ZYJB0005), the Shanghai Shenkang Hospital Development Center Clinical Management Optimization Project (Grant No. SHDC20136031), and the State Key Program of National Natural Science Foundation of China (Grant No. 71432007).
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This work was financially supported by the Department of Major Projects of the Shanghai Science and Technology Committee Foundation (Grant No. 11JC1410400), the Shanghai Health System Important Disease Joint Research Project (Grant No. 2013 ZYJB0005), the Shanghai Shenkang Hospital Development Center Clinical Management Optimization Project (Grant No. SHDC20136031), and the State Key Program of National Natural Science Foundation of China (Grant No. 71432007).
Ethical approval
This study was approved by the medical ethics committee of Hospital (Approval 2014KY004). The study was conducted in compliance with the Declaration of Helsinki.
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Informed consent was obtained from all individual participants included in the study.
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Wang, Q., Wang, Q. & Wang, J. Treatment of type B pelvic fracture using anterior subcutaneous internal fixator with triple pedicle screws: a new surgical technique. Arch Orthop Trauma Surg 137, 887–893 (2017). https://doi.org/10.1007/s00402-017-2701-3
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DOI: https://doi.org/10.1007/s00402-017-2701-3