Pararectus approach combined with three-dimensional printing for anterior plate fixation of sacral fractures

Recent Progress in the Classification and Operation of Sacral Fractures

“…Therefore, anterior plate fixation was initially indicated only for sacroiliac dislocations and partial Denis I fractures. In recent years, Huang et al reported [ 49 ] that the modified para-rectus abdominis approach was used to fix the anterior sacral plate, and the common iliac arteries and veins and the lumbosacral plexus were safely raised and retracted with a rubber catheter to protect the common iliac arteries and veins and the lumbosacral plexus under direct sight during the operation, forming the “fifth window” of the modified para-rectus abdominis approach. The two ends of the pelvic reduction forceps can be placed on sacral cone 1 and the iliac crest to reduce the sacral fracture.…”

“…The specific indications for fixation alone are unknown, and outcome data are scarce compared with combined fixation. Huang et al[ 49 ] reported the imaging and clinical results of a single-center retrospective study with more than 2 years of follow-up. Thirty-six patients and 32 patients were treated with anterior internal fixation alone or combined anterior and posterior fixation, respectively.…”

Pelvic ring injuries

“…The MFA questionnaire is a 100-item self-reported health status instrument designed by Martin et al (71) for use in a broad range of patients with musculoskeletal disorders of the extremities. Scores can range from 0 to 100, with a higher score indicating poorer function.…”

“…Not surprisingy, our findings in the systematic review are mirrored in the recently released literature, as studies on 3D operative techniques are skyrocketing. These studies showed positive results on operating time, blood loss, screw malposition rate, fracture reduction and functional outcome (71,72). Compared to 2D-assisted conventional techniques, there is subsequent evidence that 3D-assisted techniques can reduce screw malposition rate (73), operating time (73)(74)(75) and fluoroscopy frequency (75).…”

“…It is known that fracture reduction of pelvic ring injuries influences functional outcome and that patients benefit from anatomical reduction (78). Nevertheless, conflicting evidence exists on the benefits of 3D-assisted surgery for fracture reduction (71,74,75). Further, although some beneficial (73,74,79) effects on functional outcomes were shown, in other studies the evidence on this subject was lacking (75).…”