Abstract: ObjectiveTo explore the effect of percutaneous anterior pelvic internal fixation (APIF) in the treatment of complex injuries.MethodsA total of 17 complex injury cases with unstable anterior ring pelvic fractures admitted from January 2012 to May 2015 were analyzed retrospectively. According to Tile classification, there were 7 cases(7 laterals) of type B1, 5 cases(6 laterals) of B2, 2 cases(3 laterals) of C1, 2 cases(4 laterals) of C2 and 1 case of bilateral transverse acetabular fracture. All anterior ring pelvic fractures were treated by APIF. The symphysis pubis was exposed and consensual traction reduction was performed, the internal fixation of plate was carried out by the subcutaneous tunnel via the incision of anterior superior iliac spine.ResultsAll 17 cases accomplished the surgery of APIF with 23 minutes of the average operative time (ranged from 20 to 50) and 38 ml of intraoperative blood loss (ranged from 20 to 120). All 17 cases were followed up for 6 to 24 months with an average of 11 months. The outcomes revealed excellent in 13 fractures, good in 8 fractures and fair in 1 fracture according to Matta's criteria. The fracture healing time was 8 to 12 weeks with an average of 10 weeks. There was no complication as fracture nonunion, delayed union, internal fixation failure and iatrogenic neurovascular injury. The irritation of lateral femoral cutaneous nerve occurred in 2 cases and recovered spontaneously in 4 weeks. Subcutaneous foreign body sensation was found in 5 cases and disappeared after removal of internal fixators.ConclusionPercutaneous APIF is safe, mini-traumatic and reliable for unstable anterior ring pelvic fractures in complex injury without the necessity of neurovascular structures dissection.
史风雷1,王琨2,吕夫新1,孙正考1. 经皮内固定治疗复合创伤骨盆前环骨折[J]. 中国现代手术学杂志, 2017, 21(6): 428-431.
SHI Feng-lei. Percutaneous Internal Fixation for Anterior Ring Pelvic Fractures in Complex Injury. Chinese Journal of Modern Operative Surgery, 2017, 21(6): 428-431.