Minimally invasive plate osteosynthesis on anterior pelvic ring injury and anterior column acetabular fracture

Ismail, H. D.; Djaja, Yoshi Pratama; Fiolin, Jessica

doi:10.1016/j.jcot.2017.06.007

Cited by 18 publications

(21 citation statements)

References 29 publications

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“…Secondly, exposure by the ilioinguinal approach is relatively difficult because of the anatomical complexity, which can lead to prolonged operation time, increased intraoperative bleeding, and the increased possibility of iatrogenic damage to the vessels or nerves. [ 9 , 11 , 15 ] The modified ilioinguinal approach can restrict the opening to a medial and lateral window, which avoids exposure of the femoral vessels and nerves; however, bleeding is still massive during the exposure of the iliac fossa, and this procedure does not contribute to the treatment of anterior ring injuries. [ 16 , 17 ] In this study, we applied minimally invasive techniques to treat pelvic anterior ring injury, which had significant advantages:…”

Section: Discussionmentioning

confidence: 99%

“…We demonstrated shorter operation times, less intraoperative bleeding, and fewer postoperative complications with these minimally invasive internal fixation methods of treating anterior ring injuries of the pelvis compared with other methods. [ 1 , 7 , 9 , 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 , 7 ] On the contrary, open reduction internal fixation can cause extensive soft-tissue damage, wound infection, and iatrogenic injury of the nerve and vessels. [ 8 , 9 ] Recently, minimally invasive internal fixation has become the focus of research because it avoid the limitations of these traditional methods. [ 1 , 2 , 10 – 14 ] Yet, few studies have reported the indications for surgical approach and fixation type.…”

Section: Introductionmentioning

confidence: 99%

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Clinical research on minimally invasive internal fixation for the treatment of anterior ring injury in tile C pelvic fracture

Sun

Yan

Wang³

et al. 2020

Medicine

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The aim of this study is to explore the clinical outcome and indications in treating anterior ring injury of Tile C pelvic fracture with minimally invasive internal fixation. We retrospectively reviewed 18 patients (aged 25–62, 34.2 ± 7.4) with 26 pelvic anterior ring injuries of Tile C pelvic fracture treated with minimally invasive internal fixation in our hospital were from January 2012 to August 2016. Two cases were pubic symphysis diastasis, 15 were anterior ring fracture (7 were bilateral), and 1 was vertical displacement of pubic symphysis associated with pubic ramus fracture. According to Tile classification, 8, 4, and 6 cases were types C1, C2, and C3, respectively. All patients accepted the operation of pelvic fractures on both rings, while the anterior ring injuries were treated with minimally invasive internal fixation. The period from injury to operation was 5 to 32 days (11.2 ± 3.7). Four patients had pubic symphysis diastasis or pelvic anterior ring fracture medial obturator foramen reduced with modified Pfannenstiel incision and fixed with cannulated screws, 14 patients (22 fractures) had a fractured lateral obturator foramen reduced with modified Pfannenstiel incision associated with small iliac crest incision and fixed with locking reconstruction plates. Clinical data, such as operation time, intraoperative bleeding, Matta standard to assess the reduction quality of fracture, and complications, were collected and analyzed. The operation time ranged from 30 to 65 minutes (42.8 ± 18.7), and the intraoperative bleeding volume was 30 to 150 mL (66.5 ± 22.8). All cases were continuously followed-up for 16 to 42 months (30.2 ± 4.6). All fractures were healed between 3 and 9 months postoperatively (4.9 ± 2.7 months). According to the Matta standard assessment, 18, 7, and 1 cases were excellent, good, and fair, respectively, with a 96.2% (25/26) rate of satisfaction. Neither reduction loss, fixation failure, nor infection occurred; complications included 1 patient with fatal liquefaction, 1 patient had lateral femoral cutaneous nerve injury, and 1 patient complained of discomfort in the inguinal area due to fixation stimulation. Minimally invasive internal fixation for pelvic anterior ring injury in Tile C pelvic fracture has the advantages of less damage, safer manipulation, less complications, and good prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical research on minimally invasive internal fixation for the treatment of anterior ring injury in tile C pelvic fracture

Sun

Yan

Wang³

et al. 2020

Medicine

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“…limitiert invasive Zugänge Anwendung, wie die Kombination aus dem modifizierten Stoppa-Zugang und dem 1. Fenster des Letournel-Zuganges [16] oder der 2012 von Keel beschriebene Pararectuszugang [17].…”

Section: Diskussionunclassified

“…die Kombination des modifizierten Stoppa-Zuganges mit dem 1. Fenster des klassischen ilioinguinalen Zuganges nach Letournel [16] oder der Pararectuszugang nach Keel [17]. Für Verletzungen des vorderen Beckenringes und der Symphyse haben wir kürzlich einen endoskopischen Zugang (EASY Approach) analog der Versorgung von Leistenhernien beschrieben [18] Conclusion The completely endoscopic preparation of the pelvic brim and the quadrilateral plate is feasible with avail-able standard laparoscopic instruments.…”

Section: Introductionunclassified

Endoscopic Approach to the Quadrilateral Plate (EAQUAL): a New Endoscopic Approach for Plate Osteosynthesis of the Pelvic Ring and Acetabulum – a Cadaver Study

et al. 2018

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The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

Hartel

Naji

Fensky

et al. 2021

Arch Orthop Trauma Surg

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Purpose To investigate the range of indications of an anatomical-preshaped three-dimensional suprapectineal plate and to assess the impact of the bone mass density on radiologic outcomes in different types of acetabular fractures. Patients and methods A consecutive case series of 50 acetabular fractures (patient age 69 ± 23 years) treated with suprapectineal anatomic plates were analyzed in a retrospective study. The analysis included: Mechanism of injury, fracture pattern, surgical approach, need for additional total hip arthroplasty, intra- or postoperative complications, as well as bone mass density and radiological outcome on postoperative computed tomography. Results Most frequently, anterior column fracture patterns with and without hemitransverse components as well as associated two column fractures were encountered. The anterior intrapelvic approach (AIP) was used in 98% (49/50) of the cases as primary approach with additional utilization of the first window of the ilioinguinal approach in 13/50 cases (26%). Determination of bone density revealed impaired bone quality in 70% (31/44). Postoperative steps and gaps were significantly greater in this subgroup (p < 0.05). Fracture reduction quality for postoperative steps revealed anatomic results in 92% if the bone quality was normal and in 46% if impaired (p < 0.05). In seven cases (14%), the plate was utilized in combination with acute primary arthroplasty. Conclusion A preshaped suprapectineal plate provides good radiological outcomes in a variety of indications in a predominantly geriatric cohort. Impaired bone quality has a significantly higher risk of poor reduction results. In cases with extensive joint destruction, the combination with total hip arthroplasty was a valuable option.

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Minimally invasive plate osteosynthesis on anterior pelvic ring injury and anterior column acetabular fracture

Cited by 18 publications

References 29 publications

Clinical research on minimally invasive internal fixation for the treatment of anterior ring injury in tile C pelvic fracture

Clinical research on minimally invasive internal fixation for the treatment of anterior ring injury in tile C pelvic fracture

Endoscopic Approach to the Quadrilateral Plate (EAQUAL): a New Endoscopic Approach for Plate Osteosynthesis of the Pelvic Ring and Acetabulum – a Cadaver Study

The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

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