A retrospective analysis of percutaneous SI joint fixation in unstable pelvic fractures: Our experience in armed forces

Krishnan, Balasubramanian; Sharma, Yogesh; Magdum, Girish

doi:10.1016/j.mjafi.2016.01.011

Cited by 5 publications

(4 citation statements)

References 13 publications

(11 reference statements)

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“…Various ORIF technique is still the gold standard for fixation of pelvis and acetabulum fractures. ORIF like anterior, posterior plating and tension band plating is the standard method [20][21][22] . But with ORIF intra-and postoperative complications like high blood loss, infection, Heterotrophic ossification abduction mechanism failure and distortion of internal anatomy making further revision arthroplasty difficult remains major issues [16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

Prospective study of fluoroscopy guided cannulated screw fixation in pelvic ring and acetabulum fractures through percutaneous or mini incision technique

Tripathy¹,

Meena²,

Bansal³

2021

Int. J. Orthop. Sci.

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Open reduction and Internal fixation of pelvis and acetabulum fractures have required extensive surgical exposure of the deep structures of the pelvis, with problems of wound healing, damage to major vessels or nerves and infection. To overcome this percutaneous fixation of the pelvic and acetabulum fracture receiving increasing attention. Percutaneous techniques may offer advantage of soft tissue planes remain intact, which ease later arthroplasty of the hip if necessary. Percutaneous techniques may be an ideal treatment for pelvic and acetabulum in polytrauma. Advantages for percutaneous screw fixation of pelvic and acetabular fractures in these studies include less soft tissue injury, less blood loss, and a lower rate of infection. Furthermore, early weight bearing ambulation will be possible with percutaneous screw fixation. Neurovascular injuries, internal organ injuries, screw misplacement, and screw fracture are some potential complications of this technique. Aim: To investigates the clinical and radiological outcomes and complications of percutaneous screw fixation of Pelvic ring fracture and acetabulum fracture. Study design: Hospital based prospective type of observational study. Materials and Methods: After taking clearance from ethical committee a total 54 patient operated for 62 fractures and 95 cc screw were inserted through different percutaneous and mini incision (windows) approach for fracture of pelvis and acetabulum were operated based on preoperative CT SCAN in between January 2019 to November 2020. The pelvis and acetabulum fractures were classified based on young -burgess and judet-letournel classification system. The outcome variables for radiological outcome was evaluated by matta radiological score and functional outcome were evaluated by Harris hip score and Majeed pelvis score at 6 and 12 months follow up. Results: In post-operative follow up patient were started with active range of motion without weight bearing for 3 months then partially weight bear as tolerated after 3 months the respective functional Harris hip score, Majeed score were obtained at 6 and 12 months of follow up with p value of <0.001 suggesting highly significant. Matta radiological score was obtained at 12 months follow up with p value <0.001 suggesting highly significant. Conclusion: From our study we conclude that, treatment of pelvis fractures and acetabulum fracture through percutaneous approach is a challenging task for any orthopaedic surgeon with a definitive learning curve. Good preoperative evaluation, operative planning, surgical technique described above in our study, the use of 6.5 mm long cc screw in a fracture displacement of anterior column, posterior column and SI joint by buttressing of the fracture a good clinical and radiological outcome can be obtained. With good postoperative protocol and early rehabilitation it is possible to obtain improved outcome.

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Section: Discussionmentioning

confidence: 99%

Prospective study of fluoroscopy guided cannulated screw fixation in pelvic ring and acetabulum fractures through percutaneous or mini incision technique

Tripathy¹,

Meena²,

Bansal³

2021

Int. J. Orthop. Sci.

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“…Patients in the control group underwent surgery following the standard procedure, 6,13,14,15 while patients in the experimental group were operated on using a device developed by us for minimally invasive locking osteosynthesis of sacroiliac joint injuries.…”

Section: Materials Andmentioning

confidence: 99%

Comparative Assessment of Surgical Treatment Outcomes in Patients with Sacroiliac Joint Injury

Kassymov,

Zunussov,

Tlemissov

et al. 2023

BSK

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stract The aim of the study is to evaluate the results of surgical treatment in patients with sacroiliac joint injury. Methods. An analysis of the results of surgical treatment of 60 patients with sacroiliac joint injury was conducted at the Center of polytrauma and orthopedic surgery of the State Public Healthcare Institution “Emergency Hospital” in Abai Region, the Trauma and Endoprosthetics Department of the State Public Healthcare Institution “Multispecialty City Hospital No. 1” in the city of Astana, and the “Shymkent City Clinical Hospital No. 1” from June 2019 to August 2022. Patients were divided into two groups. Patients in the control group underwent surgery using the standard technique, while patients in the experimental group underwent surgery using a device developed by us for minimally invasive locking osteosynthesis of sacroiliac joint injuries. The study was a randomized controlled trial by design. Results. The use of the device for minimally invasive locking osteosynthesis of sacroiliac joint injuries leads to a significant reduction in the length of hospitalization for all types of sacroiliac joint injuries regardless of the patient’s initial condition (p=0.001). Correlation analysis revealed a correlation between the observation group and patient pain assessment at 12 months (p=0.001). According to the Majeed Pelvic Score at 12 months, the maximum score in the experimental group was 98 points, while in the control group, it was 70 points. A satisfactory assessment on the Majeed Pelvic Score at 12 months was observed in 3 (10%) of patients in the control group and none in the experimental group. There were no unsatisfactory responses in both groups (significant differences were found, p=0.001). Conclusions. The use of the device developed by us for minimally invasive locking osteosynthesis of sacroiliac joint injuries reduces the length of hospitalization and the time to return to work (12 months in the control group and 8 months in the experimental group). The absence of pain in patients after 12 months in the experimental group was 26 (86.7%) and 20 (66.6%) in the control group. According to the Majeed Pelvic Score in the long term (3, 6, and 12 months), the frequency of excellent results increases from 13.3% to 90.0% in the experimental group and from 10% to 73.4% in the control group.

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“…La fijación quirúrgica de la pelvis inestable en lesiones, proporciona una mejor reducción de fracturas, soporte de peso y movilización temprana, menores mortalidades, estancias hospitalarias más cortas y mayores resultados funcionales en comparación con el tratamiento no quirúrgico. En tal sentido, "la fijación percutánea con tornillos sacroilíacos de las fracturas pélvicas inestables tienen menos daño, menos sangrado, dolor leve, recuperación rápida, que es una cirugía mínimamente invasiva segura y eficaz" (Sharma & Magdum, 2016). Sin embargo, esta técnica no está exenta de riesgos, principalmente por consideraciones anatómicas.…”

Section: Introductionunclassified

Pelvis inestable por luxación sacroiliaca

Lucas Baño,

Alvarado Alvarado,

Gómez González

et al. 2023

RECIMUNDO

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La fractura de pelvis es considerada una lesión poco común probablemente causada por traumatismos de alto impacto. Este tipo de lesiones están infradiagnosticadas o no diagnosticadas, lo que lleva a una tratamiento y posible daño neurológico por lo que una comprensión precisa de la anatomía sacra, sus mecanismos y tipos de lesión, así como las opciones de tratamiento, es fundamental para prevenir secuelas neurológicas, como debilidad de las extremidades inferiores y disfunción urinaria, rectal o sexual. En medio de esta lesión el tratamiento quirúrgico es utilizado para restablecer la estabilidad del paciente y permitir una movilización temprana. En el abordaje se han empleado diversas técnicas de estabilización en el tratamiento de la inestabilidad pélvica, y la fijación lumbopélvica (LPF) es actualmente la técnica de elección debido a su superioridad biomecánica. Dependiendo de la localización de la fractura, la lesión neurológica puede estar presente en más del 50% de los casos. Sin embargo, debido a la naturaleza compleja de estas lesiones, el tratamiento quirúrgico sigue siendo un desafío para el cirujano tratante. Pocos son los estudios a gran escala que han abordado las complicaciones posoperatorias o los resultados a largo plazo, pero la evidencia actual sugiere que aunque las tasas de fusión son altas, la morbilidad a largo plazo, como el dolor residual y los déficits neurológicos, persiste durante muchos pacientes.

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A retrospective analysis of percutaneous SI joint fixation in unstable pelvic fractures: Our experience in armed forces

Cited by 5 publications

References 13 publications

Prospective study of fluoroscopy guided cannulated screw fixation in pelvic ring and acetabulum fractures through percutaneous or mini incision technique

Prospective study of fluoroscopy guided cannulated screw fixation in pelvic ring and acetabulum fractures through percutaneous or mini incision technique

Comparative Assessment of Surgical Treatment Outcomes in Patients with Sacroiliac Joint Injury

Pelvis inestable por luxación sacroiliaca

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