Internal versus external fixation of the anterior component in unstable fractures of the pelvic ring: pooled results from a systematic review

Wardle, Brian L.; Eslick, Guy D.; Sunner, P.

doi:10.1007/s00068-015-0554-4

Cited by 15 publications

(9 citation statements)

References 32 publications

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“…The external fixator was preferred for the anterior ring, by four of the seven hospitals. The external pelvic fixator has been reported as a valuable tool for the elderly 43 , but it may be complicated by frequent loosening or pin tract infections 44 , 45 . Retrograde transpubic screw fixation has yielded good results in terms of fracture reduction and healing, with only a small number of adverse events (17 of 128 cases) reported by a large retrospective series 46 .…”

Section: Discussionmentioning

confidence: 99%

A computed tomography based survey study investigating the agreement of the therapeutic strategy for fragility fractures of the pelvis

Pieroh

Hohmann

Gras

et al. 2022

Sci Rep

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Treatment recommendations for fragility fractures of the pelvis (FFP) have been provided along with the good reliable FFP classification but they are not proven in large studies and recent reports challenge these recommendations. Thus, we aimed to determine the usefulness of the FFP classification determining the treatment strategy and favored procedures in six level 1 trauma centers. Sixty cases of FFP were evaluated by six experienced pelvic surgeons, six inexperienced surgeons in training, and one surgeon trained by the originator of the FFP classification during three repeating sessions using computed tomography scans with multiplanar reconstruction. The intra-rater reliability and inter-rater reliability for therapeutic decisions (non-operative treatment vs. operative treatment) were moderate, with Fleiss kappa coefficients of 0.54 (95% confidence interval [CI] 0.44–0.62) and 0.42 (95% CI 0.34–0.49). We found a therapeutic disagreement predominantly for FFP II related to a preferred operative therapy for FFP II. Operative treated cases were generally treated with an anterior–posterior fixation. Despite the consensus on an anterior–posterior fixation, the chosen procedures are highly variable and most plausible based on the surgeon’s preference.

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Section: Discussionmentioning

confidence: 99%

A computed tomography based survey study investigating the agreement of the therapeutic strategy for fragility fractures of the pelvis

Pieroh

Hohmann

Gras

et al. 2022

Sci Rep

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“…For the anterior ring, Vaidya [18,26] suggested INFIX indications included superior ramus pubis, inferior ramus pubis, and bilateral ramus pubis fractures. All 17 patients in this group received an INFIX fixator and one successful screw placement.…”

Section: Discussionmentioning

confidence: 99%

“…For anterior ring injury, traditional fixation methods include external fixation, open reduction plate fixation, X-ray guidance for ramus screw fixation, and open Stoppa approach surgery [18]. The INFIX, a new minimally invasive method for the treatment of unstable pelvic fractures, was described in 2011 with little trauma and little impact on patients' daily activities [19].…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted treatment of unstable pelvic fractures with a percutaneous iliac lumbar double rod fixation combined with a percutaneous pelvic anterior ring INFIX fixation

Sun

Ding

et al. 2020

International Orthopaedics (SICOT)

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Objective To investigate the clinical effect of robot-assisted treatment of unstable pelvic fractures through a percutaneous iliac lumbar double rod fixation combined with a percutaneous pelvic anterior ring INFIX (internal fixator) fixation. Methods This was a retrospective analysis of 17 cases of unstable anterior and posterior pelvic ring fractures treated between April 2016 and October 2018 by the third Ti-robot system produced in China. The posterior ring was supported with an iliac lumbar double rod fixation and the anterior ring with an INFIX fixation. Operation time and peri-operative bleeding were recorded. The reduction of pelvic fracture displacement was evaluated by Matta score, the post-operative results were evaluated according to Majeed score, and the complications were recorded. Results Twelve males and five females, aged 21–71 years (mean 40.1 ± 3.8 years) were followed up for three to 12 months, (median 6.7 months). Tile typing showed seven B1 type, two B2 type, and eight C1 type cases. Operation time was 90–160 minutes (mean 112.9 ± 16.8 minutes), bleeding was 80–150 mL (mean 105.9 ± 20.6 mL). X-ray three to five days after operation was evaluated by Matta score as excellent in 15 and good in two cases. Majeed score at last follow-up was 85–98 points, excellent in 17 cases. Two cases of lower extremity deep vein thrombosis received an inferior vena cava filter. The filters were removed after two weeks. One case showed incision fat liquefaction healing and the wound healed three weeks after surgery. Conclusion Orthopedic robot-assisted treatment of unstable pelvic fractures by a percutaneous iliac lumbar double rod fixation and a percutaneous pelvic anterior ring INFIX fixator was minimally invasive and feasible. A prospective study is needed.

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“…Since the presented data reflect only short-term results, the status cannot be evaluated after healing. A meta-analysis for this problem concluded that internal fixation of the anterior pelvic ring as supplementary fixation for unstable injuries of the pelvic ring resulted in better radiographic and functional outcomes as well as fewer complications 19 , but clear inclusion criteria regarding the quality of the studies, the type of fractures treated, the kind of osteosynthetic fixation or the follow-up period were not defined. A quantitative analysis based on this unreliable data set is fairly misleading and not suitable as a basis for treatment guidelines.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of strategies for the treatment of type B and C pelvic fractures

Schmal

Froberg

Larsen

et al. 2018

The Bone & Joint Journal

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Internal versus external fixation of the anterior component in unstable fractures of the pelvic ring: pooled results from a systematic review

Cited by 15 publications

References 32 publications

A computed tomography based survey study investigating the agreement of the therapeutic strategy for fragility fractures of the pelvis

A computed tomography based survey study investigating the agreement of the therapeutic strategy for fragility fractures of the pelvis

Robot-assisted treatment of unstable pelvic fractures with a percutaneous iliac lumbar double rod fixation combined with a percutaneous pelvic anterior ring INFIX fixation

Evaluation of strategies for the treatment of type B and C pelvic fractures

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