Minimally invasive internal fixation for unstable pelvic ring fractures: a retrospective study of 27 cases
INFIX with or without sacroiliac screws can achieve satisfactory radiographic and functional results in the treatment of unstable pelvic ring fractures.
Wu, S., Chen, J., Yang, Y., et al. Minimally invasive internal fixation for unstable pelvic ring fractures: a retrospective study of 27 cases. J Orthopaedics Surg RES 16, 350 (2021). https://doi.org/10.1186/s13018-021-02387-5
Commentary
The purpose of this study was to evaluate the radiographic and clinical results of anterior subcutaneous internal fixation with or without posterior fixation (INFIX) treating unstable pelvic fractures.
Intraoperative blood loss, operative time, and hospital stay were recorded, fracture healing and postoperative complications were assessed, and the quality of fracture repair was evaluated using the Matta score, pelvic deformity index (PDI), and pubic symphysis width (PSW).
As a result, 27 patients (14 males and 13 females) with a mean age of 37.4 years were followed up for an average of 22 months, with mean operative time, median intraoperative blood loss, and mean hospital stay of 129 ± 47 minutes, 100 mL, and 22 ± 13 days, respectively. All patients achieved bony union, with a mean union time of 13.3 weeks and mean PDI and PSW before and after surgery of 0.07 ± 0.04 vs. 0.04 ± 0.03 (P = 0.009) and 1.15 ± 1.36 vs. 0.54 ± 0.17 (P = 0.048), respectively. Seventy-eight percent of these patients had excellent or good Matta or Majeed scores, with SF-12 physical and mental health scores of 45.1 ± 10.2 and 53.2 ± 6.3, respectively.
Reports related to adverse events included 1 superficial surgical site infection, 1 loosening of INFIX, 1 lateral femoral cutaneous nerve irritation, 1 femoral nerve injury, 2 discomfort of the implant due to the bar, and of the 5 patients with sacral nerve injury, 4 were asymptomatic and 1 had only abnormal sensation at the last follow-up.
There are several limitations to these results: first, only the postoperative functional scores were recorded. The follow-up period was not too long. It was a single-center retrospective case series with inherent limitations of the study design, including the absence of a control group, standardized surgical indications, and a heterogeneous study population in terms of demographic and injury characteristics. postoperative complications, and further research on technical changes in INFIX.
