Percutaneous Versus Open Treatment of Posterior Pelvic Ring Injuries: Changes in Practice Patterns Over Time

Gire, Jacob D.; Jiang, Sam Y.; Gardner, Michael J.; Bishop, Julius A.

doi:10.1097/bot.0000000000001236

Cited by 13 publications

(9 citation statements)

References 29 publications

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“…Triangular osteosynthesis also allows for percutaneous application, a technique that has become increasingly common among trauma surgeons. Both open and percutaneous techniques were shown to produce similar, good, or excellent reductions [ 8 ]. Limitations to percutaneous fixation include: inadequate percutaneous reduction of sacroiliac joints, associated acetabular fracture necessitating open reduction, poor intraoperative imaging such as abundant bowel gas or intra-abdominal contrast agents, sacral dysmorphism preventing safe passage of percutaneous screws, and the presence of neurologic injuries where decompression is indicated [ 6 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral vertical shear sacroiliac joint dislocations treated with bilateral triangular osteosynthesis in a young female: A case report

Steelman

Russell

Vaidya

2021

Trauma Case Reports

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Case Type C pelvic ring fractures account for only 0.34% of all pelvic fractures (Zhang, 2012 [1]). Anterior and posterior pelvic fixation is necessary in these injuries and can be accomplished using a variety of techniques. This study presents a case of bilateral vertical shear sacroiliac joint dislocations with an associated hip dislocation and pubic rami fractures that was treated with bilateral triangular osteosynthesis and INFIX. Conclusion This is the first reported case of bilateral vertical shear sacroiliac joint dislocation treated with triangular osteosynthesis. Anterior pelvic fixation with INFIX and posterior fixation with lumbopelvic and percutaneous sacroiliac screws resulted in excellent radiographic and clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Bilateral vertical shear sacroiliac joint dislocations treated with bilateral triangular osteosynthesis in a young female: A case report

Steelman

Russell

Vaidya

2021

Trauma Case Reports

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“…The treatment method is an important factor that can influence the functional outcomes [1]. Optimal treatment for unstable fractures of the pelvis is not yet defined [13]. The ORIF technique includes anterior and posterior approaches.…”

Section: Discussionmentioning

confidence: 99%

Results of open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable pelvic ring injuries: retrospective study of 36 patients

Abou-Khalil

Steinmetz

Mustaki

et al. 2020

Eur J Orthop Surg Traumatol

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Introduction Surgical stabilization of posterior pelvic ring fractures can be achieved by closed reduction and percutaneous fixation (CRPF) or by open reduction and internal fixation (ORIF). The aim of the present study is to compare the clinical results of both methods. Material and methods Medical records of 36 patients consecutively operated for unstable pelvic ring injuries were retrospectively reviewed. We compared 22 patients treated with CRPF versus 14 patients stabilized by using ORIF between 2007 and 2017. The Majeed and Pohlemann scores were used to evaluate postoperative functional outcomes. Complications like blood loss, infection rate, Neurological injury, the operative time and the length of hospital stay were analyzed. Results The median Majeed pelvic score was 87 points for the CRPF technique compared with 69 points for the ORIF technique. The median Pohlemann score, operative time and length of hospitalization were similar between the two groups. The median blood loss for the CRPF technique was 300 ml compared to 500 ml for the ORIF technique. CRPF and ORIF procedure had each one neurological lesion. There was one case of infection in the ORIF group and none in the CRPF group. No measurements except for the blood loss have reached the significance threshold. Conclusion The CRPF technique shows a clear decrease in blood loss. There was no statistically significant difference in the functional results, infection rate, neurological injury, operative time and hospital stay between both techniques.

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“…The Pfannenstiel and ilioinguinal approaches may injure the bladder, spermatic cord, iliac vessels, and the femoral and lateral thigh nerves; and/or trigger herniation [ 9 ]. Developments in percutaneous screws since the 1990s have reduced intraoperative comorbidities, blood loss, operative time, negative post-operative outcomes, decubitus complications, and the infection rate; and facilitate early mobilization [ 10 , 11 ]. However, percutaneous screwing remains somewhat risky and technically challenging [ 2 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

The first use of laparoscopy to treat pelvic ring fractures: A case report

Francia¹,

Tanner²,

Marolleau³

2020

International Journal of Surgery Case Reports

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Highlights The first use of laparoscopy to treat pelvic ring fractures: a case report. We describe the first use of laparoscopy to treat pelvic ring fracture. This “laparoscopic internal fixation” delivered an in situ result as good as that of open surgery. Despite a long operating time, the blood loss was very low. This technique opens a new approach to treatment of pelvic fractures.

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Percutaneous Versus Open Treatment of Posterior Pelvic Ring Injuries: Changes in Practice Patterns Over Time

Abstract: Early-career orthopaedic surgeons are performing more percutaneous fixation of the posterior pelvic ring and less open surgery. The impact of this change in volume on surgeon proficiency is unknown and warrants additional research.

Cited by 13 publications

References 29 publications

Bilateral vertical shear sacroiliac joint dislocations treated with bilateral triangular osteosynthesis in a young female: A case report

Bilateral vertical shear sacroiliac joint dislocations treated with bilateral triangular osteosynthesis in a young female: A case report

Results of open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable pelvic ring injuries: retrospective study of 36 patients

The first use of laparoscopy to treat pelvic ring fractures: A case report

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