A Countertraction Closed Reduction Technique in Minimally Invasive Fixation of Recent Type C Pelvic Ring Injuries

Abstract

Purpose: This study demonstrated a novel traction technique for closed reduction called countertraction closed reduction technique (CCRT) and evaluated its effectiveness. Methods: The data of Patients with unstable pelvic fractures treated with CCRT and minimally invasive fixation for unstable pelvic fracture, admitted to the second affiliated hospital of Guangxi Medical University from January 2017 to February 2022, were analyzed retrospectively. The CCRT was performed in patients with a fresh Tile C pelvic fracture. A sacroiliac screw was then placed to fix the posterior pelvic ring, and internal or external fixation was used to fix the anterior pelvic ring. Operation time, intraoperative blood loss, and duration of hospital stay were recorded, and fracture union and postoperative complications were evaluated. Fracture reduction quality was evaluated using the Matta score. Functional recovery and general quality of life were evaluated using the Majeed score. Results: Thirteen patients (nine males and four females), with an average age of 49.6 years were followed up for a mean of 18.5 months. The average operation time was 137.2 minutes (range 92–195 minutes), the average intraoperative blood loss was 31.2 ml (range 10–120 ml) and the average duration of hospital stay was 14.3 days (range 4-32 days). All patients achieved bony union with an average union time of 11.9 weeks (range 10-16 weeks). According to the Matta radiographic criteria, the quality of fracture reduction was excellent in eight patients, good in four, and fair in one. The average Majeed functional score was 89.7 (range 78-100). The functional evaluation revealed that the outcomes were excellent in nine patients, and good in four patients. Complications included incision fat liquefaction in one patient, and heterotopic ossification in another patient. There were no surgical complications as a result of CCRT. Conclusion: CCRT is an alternative closed reduction method for minimally invasive fixation of fresh Tile C1 and C2 pelvic fractures. Its advantages include a small surgical incision, decreased intraoperative bleeding, satisfactory fracture reduction, bone healing and functional recovery.