当前位置： SCI文献检索 > CLINICAL ORTHOPAEDICS AND RELATED RESEARCH期刊下所有文献 > A minimally invasive stabilizing system for dorsal pelvic ring injuries.

A minimally invasive stabilizing system for dorsal pelvic ring injuries.

Abstract：

BACKGROUND:Open reduction and stabilization of dorsal pelvic ring injuries is accompanied by a high rate of soft tissue complications. Minimally invasive techniques have the potential to decrease soft tissue trauma, but the risk of iatrogenic nerve and vessel damage through the reduced surgical exposure should be considered. We treated these injuries using a transiliac internal fixator (TIFI) in a minimally invasive technique characterized by implantation of a pedicle screw and rod system, bridging the sacroiliac joints and the sacral area. QUESTIONS/PURPOSES:We asked whether (1) we could achieve anatomic restoration with the device, (2) specific complications were associated with this minimally invasive approach (particularly enhanced intraoperative blood loss, soft tissue complications, and iatrogenic neurovascular damage), and (3) function 3 years after trauma was comparable to that of established methods. METHODS:We retrospectively reviewed 67 patients with dorsal pelvic injuries during a 7-year period. We evaluated the (1) reduction by grading the maximal displacement measured with three radiographic views, (2) the complications during the observation period, and (3) the function with a validated questionnaire (Pelvic Outcome Score) in all but five patients at least 3 years after trauma (mean, 37 months; range, 36-42 months). RESULTS:At last followup we observed a secondary fracture displacement greater than 5 mm in one patient. The intraoperative blood loss was less than 50 mL in all patients. No neurovascular lesions occurred owing to implantation. Four patients had wound infections, one had loosening of a single pedicle screw, and one had an iatrogenic screw malpositioning. Thirty-five of the 62 patients achieved Pelvic Outcome Scores of either a maximum score or 6 of 7 points. CONCLUSION:Our observations suggest TIFI is a reasonable alternative to other established fixation devices for injuries of the dorsal pelvic ring with minor risks of major blood loss or iatrogenic neurovascular damage. LEVEL OF EVIDENCE:Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

journal_name

Clin Orthop Relat Res

journal_title

Clinical orthopaedics and related research

authors

Dienstknecht T,Berner A,Lenich A,Nerlich M,Fuechtmeier B

doi

10.1007/s11999-011-1922-y

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

3209-17

issue

eissn

0009-921X

issn

1528-1132

journal_volume

469

pub_type

杂志文章

在线工具

A minimally invasive stabilizing system for dorsal pelvic ring injuries.