Minimally invasive treatment for pubic ramus fractures combined with a sacroiliac joint complex injury

Yu, Xiaowei; Tang, Mingjie; Zhou, Zubin; Peng, Xiaochun; Wu, Tianyi; Sun, Yifeng

doi:10.1007/s00264-013-1954-x

Cited by 13 publications

(11 citation statements)

References 20 publications

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“…There has been an increasing interest in minimally invasive plate osteosynthesis for anterior pelvic fixation with less trauma and better stability. 11 , 17 Nevertheless, neurovascular injuries may occur because of difficulty in dissection and a prolonged learning time. Additionally, the ligaments and muscle are partially excised during exposure of the medial window, which may cause hernias.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the ligaments and muscle are partially excised during exposure of the medial window, which may cause hernias. 11 For posterior plate osteosynthesis, suitable bending of the plates intraoperatively is technically demanding and sometimes difficult to achieve. The plate may also easily irritate local soft tissue and cause discomfort in the supine position.…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive treatment of unstable pelvic ring injuries with modified pedicle screw–rod fixator

Liu

et al. 2017

J Int Med Res

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ObjectiveTo evaluate the clinical application of the minimally invasive modified pedicle screw–rod fixator for unstable pelvic ring injuries, including its feasibility, merits, and limitations.MethodsTwenty-three patients (13 males, 10 females; average age, 36.3 years) with unstable pelvic ring injuries underwent anterior fixation using a modified pedicle screw–rod fixator with or without posterior fixation using a transiliac internal fixator. The clinical findings were assessed using Majeed scores. The quality of reduction was evaluated using the Matta criteria.ResultsClinical results at 1 year postoperatively were excellent in 14 patients, good in 7, and fair in 2. The two patients with fair results had intermittent pain at the sacroiliac joint because of the posterior implant. One woman complained of persistent pain at the pubic tubercle during sexual intercourse. Iatrogenic neuropraxia of the unilateral lateral femoral cutaneous nerve occurred in three patients. Unilateral femoral nerve palsy occurred in one patient. The quality of fracture reduction was excellent in 12 patients, good in 8, and fair in 3. Heterotopic ossification occurred in eight patients; all were asymptomatic.ConclusionsMinimally invasive modified pedicle screw-rod fixation is an effective alternative treatment for pelvic ring injuries.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimally invasive treatment of unstable pelvic ring injuries with modified pedicle screw–rod fixator

Liu

et al. 2017

J Int Med Res

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“…The concept of minimally invasive plate osteosynthesis in pelvic fractures has recently been introduced. Yu et al introduced a minimally invasive plate osteosynthesis technique for pubic ramus fracture treatment [ 17 ]. Owing to the lack of direct visualization, some anatomic structures, including LFCN, the femoral artery, femoral vein, femoral nerve, and the round ligament in women or the spermatic cord in men, are theoretically at risk of injury during implant placement.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive treatment for anterior pelvic ring injuries with modified pedicle screw-rod fixation: a retrospective study

Hung

et al. 2018

J Orthop Surg Res

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BackgroundPelvic ring injuries constitute only 2 to 8% of all fractures; however, they occur in 20% of polytrauma patients. High-energy pelvic fractures often result in mechanical instability of the pelvic ring. Successful treatment of unstable pelvic ring fractures remains a challenge for orthopedic surgeons. This study presents a novel internal fixation method for stabilizing unstable anterior pelvic ring fractures using a minimally invasive modified pedicle screw-rod fixation (MPSRF) technique.MethodsThis retrospective study included six patients with unstable pelvic ring injuries who underwent MPSRF, with or without posterior fixation. Intraoperative parameters such as blood loss, operative time, complications, and quality of reduction (Matta criteria) were recorded and evaluated by a blinded reviewer.ResultsIn the present clinical series, the mean operative times and mean blood loss for unilateral versus bilateral anterior ring fixations were 176.0 min versus 295.6 min, and 153.3 mL versus 550.0 mL, respectively. No iatrogenic neuropraxia of the lateral femoral cutaneous nerve or femoral nerve palsy occurred. The reduction quality, graded by the Matta criteria, was excellent in five patients and good in one patient.ConclusionsThere were no infections, delayed unions, nonunions, or loss of reductions during the follow-up period. Only one patient suffered from a broken rod at 4 months postoperatively. The modified technique represents a novel, minimally invasive procedure for the treatment of anterior pelvic ring fractures and offers a reliable and effective alternative to currently available surgical techniques.

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“…Thus, it could be used only in patients who have residual instability anteriorly after the posterior pelvis has been verified to be stable. Yu [ 27 ] et al introduced a similar minimally invasive plate osteosynthesis (MIPO) technique for the treatment of pubic ramus fractures in 15 patients. For exposure of the medial window, the ligaments and the pyramidal muscle were partially excised in their study, which may cause hernias because of the abdominal exposure.…”

Section: Discussionmentioning

confidence: 99%

Treatment of pelvic fractures through a less invasive ilioinguinal approach combined with a minimally invasive posterior approach

Zhu

Wang

Shen

et al. 2015

BMC Musculoskelet Disord

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BackgroundUnstable pelvic fractures usually result from high-energy trauma. There are several treatment modalities available. The purpose of this study was to evaluate the clinical application of a new less invasive ilioinguinal approach combined with a minimally invasive posterior approach technique in patients with unstable pelvic fractures. We also address the feasibility, validity, and limitations of the technique.MethodsThirty-seven patients with unstable pelvic fractures were treated with our minimally invasive technique. The anterior pelvic ring fractures were treated with a less invasive ilioinguinal approach, and the sacral fractures were treated with a minimally invasive posterior approach. The clinical outcome was measured using the Majeed scoring system, and the quality of fracture reduction was evaluated. The patients were followed up for 13 to 60 months (mean, 24 months).ResultsAnatomical or near to anatomical reduction was achieved in 26 (70.3 %) of the anterior pelvic ring fractures and a satisfactory result was obtained in another 11(29.7 %). For the posterior sacral fractures, excellent reduction was obtained in 33 (89.2 %) of the fractures, with a residual deformity in the other 4 patients. One superficial wound infection and two deep vein thromboses occurred, all of which resolved with conservative treatment. The clinical outcome at one year was “excellent” in 29 patients and “good” in 8 patients (Majeed score).ConclusionsThe satisfactory results showed that a reduction and fixation of unstable pelvic fractures is possible through a combination of a limited ilioinguinal approach and posterior pelvic ring fixation. We believe our method is a new and effective alternative in the management of pelvic fractures.

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Minimally invasive treatment for pubic ramus fractures combined with a sacroiliac joint complex injury

Cited by 13 publications

References 20 publications

Minimally invasive treatment of unstable pelvic ring injuries with modified pedicle screw–rod fixator

Minimally invasive treatment of unstable pelvic ring injuries with modified pedicle screw–rod fixator

Minimally invasive treatment for anterior pelvic ring injuries with modified pedicle screw-rod fixation: a retrospective study

Treatment of pelvic fractures through a less invasive ilioinguinal approach combined with a minimally invasive posterior approach

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