A new study published in the Chinese Journal of Reparative and Reconstructive Surgery assessed the effectiveness of anterior subcutaneous internal fixation (INFIX) combined with posterior percutaneous iliosacral screw in the treatment of unstable pelvic fractures.

In this study, 14 males and 5 females with an age-range of 17-69 years, were selected; overall, 19 cases of unstable pelvic fractures were treated with anterior subcutaneous INFIX combined with posterior percutaneous iliosacral screw. According to Tile classification, there were two cases of type B1; six cases of type B2; and 11 cases of type C. The intraoperative blood loss and operation time were recorded and the fracture healing and postoperative complications were observed.

The operation time was 47-123 minutes and the intraoperative blood loss was 50-115 ml. One case had superficial infection at the site of screw implantation and another had unilateral cutaneous nerve stimulation, which were cured after corresponding treatment. There was no damage to the urinary system, reproductive system and intestine. All cases were followed up 12-25 months; all fractures healed after operation – the average healing time was 9.5 weeks. The results revealed no incidence of nonunion, delayed healing, internal fixation loosening, fracture or other complications. Meanwhile, of the two patients with lumbosacral plexus injury before operation, one recovered completely whereas, another had residual mild claudication. At last follow-up, the reduction of fracture was found to be excellent in 13 cases and good in 6 cases with an excellent and good rate of 100%, according to the Matta scoring standard. Resultant function was deemed excellent in 15 cases and good in 4 cases with an excellent and good rate of 100%, based on the Majeed scoring standard.

The findings suggested that minimally invasive pelvic stabilization by using anterior subcutaneous INFIX and posterior percutaneous iliosacral screw for the treatment of unstable pelvic fractures, can achieve good fracture reduction and definitive stabilization with minimum complications and obtain excellent functional outcomes.

Source: Chinese Journal of Reparative and Reconstructive Surgery. 2020 Jan 15;34(1):21-26. doi: 10.7507/1002-1892.201905098.