Minimally invasive internal fixator for unstable pelvic ring injuries with a pedicle screw–rod system: a retrospective study of 23 patients after 13.5 months

Hua, Xingyi; Yan, Shuang G; Cui, Yiliang; Yin, Zongsheng; Schreiner, Anna J.; Schmidutz, Florian

doi:10.1007/s00402-018-3094-7

Cited by 18 publications

(22 citation statements)

References 28 publications

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“…Pelvic ring injuries have a prevalence of 20–37/100,000 in the general population and are often caused by severe accidents [1]. Most pelvic ring injuries are caused by (blunt force) high-energy trauma [2], with the majority of the causes being motor vehicle collisions [3, 4]. However, pelvic ring injuries in the elderly are often caused by low-energy accidents, such as a fall on a slippery surface.…”

Section: Introductionmentioning

confidence: 99%

Long-term physical functioning and quality of life after pelvic ring injuries

Banierink

Reininga

Heineman

et al. 2019

Arch Orthop Trauma Surg

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Background Pelvic ring injuries are serious injuries, often associated with substantial morbidity and mortality rates. The long-term consequences of these injuries might affect the patients’ personal life. Our aim was to assess the long-term effects of pelvic ring injuries on physical functioning and quality of life (QoL) using validated patient-reported outcome measures (PROMs) and comparing these results to normative data from the general population. Patients and methods A retrospective cohort study was conducted on adults treated for pelvic ring injuries between 2007 and 2016. Demographics, fracture type, injury mechanism, treatment and complications were recorded. PROMs questionnaires concerning physical functioning (SMFA) and quality of life (EQ-5D) were used. Patients were divided according to their age (18–30, 31–64, 65 and older) and fracture type (Tile/AO type A, B or C). Differences in SMFA and EQ-5D scores of the operatively and non-operatively treated patients and between the study population and general population were analyzed. Results A total of 413 patients were identified of which 279 were eligible for follow-up. One-hundred and ninety-two (69%) patients responded with a mean follow-up of 4.4 years. Patients reported a median score of 13.9 on the SMFA function index, 16.7 on the bother index, 12.5 on the lower extremity, 18.8 on the activities of daily living and 23.4 on the emotion subscale. A median EQ-5D score of 0.8 was reported. There was no difference in physical functioning and QoL between operatively and non-operatively treated patients. Comparison of these results to normative data of the general population revealed a significant ( P < 0.05) decrease in physical functioning and QoL in patients with all types of pelvic ring injuries. Conclusion Long-term physical functioning and QoL in patients who had sustained a pelvic ring injury seems fair, although significantly decreased in comparison with their peers from the general population.

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Section: Introductionmentioning

confidence: 99%

Long-term physical functioning and quality of life after pelvic ring injuries

Banierink

Reininga

Heineman

et al. 2019

Arch Orthop Trauma Surg

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“…The purpose of surgical fixation is reconstruction of the lumbopelvic area to avoid malunion and allow early weight-bearing. The transiliac plate 2,3 , sacroiliac screws 4,5 , and transiliac rods fixation 6,7 can be optimal options for posterior pelvic ring injuries. However, all of above are unable to stabilize the lumbopelvic junction.…”

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confidence: 99%

Robot‐Aided Minimally Invasive Lumbopelvic Fixation in Treatment of Traumatic Spinopelvic Dissociation

Liu

Tian

et al. 2021

Orthopaedic Surgery

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Objective: To investigate the surgical strategy, safety, and efficacy of close reduction and robot-aided minimally invasive lumbopelvic fixation in treatment of traumatic spinopelvic dissociation. Methods: Data of 32 patients (21 males and 11 females) with traumatic spinopelvic dissociation treated by lumbopelvic fixation with robot-aided minimally invasive technique or conventional open procedure in our institution from March 2010 to April 2019 were retrospectively analyzed, and divided into robot group and control group. Intraoperative blood loss, surgical time, fluoroscopy frequency, total drilling times, infection rate, hospitalization time, and sacral fracture healing time were reviewed. Radiographs and computed tomography (CT) scans were totally acquired to evaluate the reduction quality, residual fracture displacement, and Gras classification on screws insertion after surgery. According to the Majeed scoring system, functional outcome was assessed for each patient at the final follow-up. Results: There were 12 patients in the robot group and 20 patients in the control group with no significant difference about the demographic data. The average surgical time was 148.3 ± 40.5 min with intraoperative blood loss of 142.5±36.7 mL in the robot group and 185.0 ± 47.8 min with 612.5 ± 182.7 mL in the control group (P = 0.034, P = 0.000). The robot group had a shorter mean hospitalization time at 19.9 ± 7.0 days compared to the control group with 28.6 ± 5.4 days (P = 0.010). The fluoroscopy frequency was 35.4 ± 3.0 in the robot group and 45.5 ± 3.6 in the control group (P = 0.000) and total drilling times were 7.1 ± 1.1 and 9.6 ± 1.3 (P = 0.000), respectively. The infection rate was 0% (0/12) in the robot group and 15% (3/20) in the control group (P = 0.159). According to the Gras classification on screw positioning, there were 11 cases in Grade I and 1 case in Grade II in the robot group, and 14 cases in Grade I and 6 cases in Grade II in the control group. All the patients were followed up consecutively for at least 12 months, with an average follow-up period of 17.1 ± 3.6 months. All sacral fractures healed with an average time of 3.8 ± 0.6 months in the robot group and 4.7 ± 0.7 months in the control group (P = 0.000). According to Majeed functional assessment investigation, the mean score of the patients was 87.2 ± 4.0 in the robot group and 83.1 ± 4.5 in the control group (P = 0.015). Conclusions: Robot-aided minimally invasive lumbopelvic fixation for traumatic spinopelvic dissociation is a safe and feasible option with advantages of less intraoperative blood loss, less radiation damage, less hospitalization time, and better functional outcome.

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“…Balbachevsky et al reported that external fixation is used for more than 79.5% of patients with a pelvic fracture, especially for patients with multiple injuries and soft tissue damage (1). However, clinical follow-up results showed that external fixation frequently causes infections and pin loosening (in more than 50% patients) and does not effectively stabilize the pelvis, indicating that the current method of external fixation needs to be improved clinically [17,18].…”

Section: Discussionmentioning

confidence: 99%

A feasibility study of individual 3D-printed navigation template for the deep external fixator pin position on the iliac crest

Liang

Chen

Liu

et al. 2020

BMC Musculoskelet Disord

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Background: The aim of this study was to investigate the feasibility of an individual navigation template for the deep pin position on the iliac crest, based on digital design and 3D printing technology. Methods: The preoperative CT images of 8 patients with pelvic fractures were collected. The data were reconstructed using a 3D imaging reconstruction workstation. An individual navigation template for the deep pin position on the iliac crest was designed on a virtual 3D model. The individual drill template and the solid pelvic model were produced using the 3D printing technology. The individual drill template was used for intraoperative deep pin position on the iliac crest after the preoperative simulation was completed. Results: Thirty-two external fixator pins were inserted using the individual drill template. The average depth of pins was 84.82 mm. The trajectories were appropriate based on the postoperative X-ray and CT scan. No significant difference in the entry point, convergence angle, and caudal angle of the pins were noted before and after the operation (all P > 0.05). Finite element analysis indicated that the deep external fixator pin position could more reasonably distribute the stress in the cortical and spongy bones in the pelvis. All patients could perform partial weight-bearing activity 6 weeks postoperatively. No loosening and rupture of the pin, infection, and no damage of blood vessels and nervous tissue were found during the entire follow-up period. Conclusions: The individual drill template technique is an improvement of the traditional technique, which could increase precision and the depth of pin position. In addition, good mechanical stability and low risk of pin-related complications occurred due to the individual drill template, which makes the external fixation technique a potential alternative.

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Minimally invasive internal fixator for unstable pelvic ring injuries with a pedicle screw–rod system: a retrospective study of 23 patients after 13.5 months

Cited by 18 publications

References 28 publications

Long-term physical functioning and quality of life after pelvic ring injuries

Long-term physical functioning and quality of life after pelvic ring injuries

Robot‐Aided Minimally Invasive Lumbopelvic Fixation in Treatment of Traumatic Spinopelvic Dissociation

A feasibility study of individual 3D-printed navigation template for the deep external fixator pin position on the iliac crest

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