Anterior subcutaneous internal fixation for treatment of unstable pelvic fractures

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• 作者：Max J Scheyerer (20)
  Stefan M Zimmermann (20)
  Georg Osterhoff (20)
  Simon Tiziani (20)
  Hans-Peter Simmen (20)
  Guido A Wanner (20)
  Clèment ML Werner (20)
  
• 关键词：Pelvic ring fracture ; Rupture of the symphysis pubis ; Internal fixator ; Anterior subcutaneous fixator
• 刊名：BMC Research Notes
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：7
• 期：1
• 全文大小：843 KB
• 参考文献：1. Giannoudis PV, Pape HC: Damage control orthopaedics in unstable pelvic ring injuries. / Injury 2004, 35:671-77. CrossRef
  2. Grotz MR, Allami MK, Harwood P, Pape HC, Krettek C, Giannoudis PV: Open pelvic fractures: epidemiology, current concepts of management and outcome. / Injury 2005, 36:1-3. CrossRef
  3. Gansslen A, Pohlemann T, Paul C, Lobenhoffer P, Tscherne H: Epidemiology of pelvic ring injuries. / Injury 1996,27(Suppl 1):S-A13-S-A20. CrossRef
  4. Demetriades D, Karaiskakis M, Toutouzas K, Alo K, Velmahos G, Chan L: Pelvic fractures: epidemiology and predictors of associated abdominal injuries and outcomes. / J Am Coll Surg 2002, 195:1-0. CrossRef
  5. Gilliland MD, Ward RE, Barton RM, Miller PW, Duke JH: Factors affecting mortality in pelvic fractures. / J Trauma 1982, 22:691-93. CrossRef
  6. Pohlemann T, Tscherne H, Baumgartel F, Egbers HJ, Euler E, Maurer F, Fell M, Mayr E, Quirini WW, Schlickewei W, Weinberg A: Pelvic fractures: epidemiology, therapy and long-term outcome. Overview of the multicenter study of the Pelvis Study Group. / Unfallchirurg 1996, 99:160-67. CrossRef
  7. Poole GV, Ward EF: Causes of mortality in patients with pelvic fractures. / Orthopedics 1994, 17:691-96.
  8. Smith W, Williams A, Agudelo J, Shannon M, Morgan S, Stahel P, Moore E: Early predictors of mortality in hemodynamically unstable pelvis fractures. / J Orthop Trauma 2007, 21:31-7. CrossRef
  9. Blackmore CC, Cummings P, Jurkovich GJ, Linnau KF, Hoffer EK, Rivara FP: Predicting major hemorrhage in patients with pelvic fracture. / J Trauma 2006, 61:346-52. CrossRef
  10. Schmal H, Markmiller M, Mehlhorn AT, Sudkamp NP: Epidemiology and outcome of complex pelvic injury. / Acta Orthop Belg 2005, 71:41-7.
  11. Mohanty K, Musso D, Powell JN, Kortbeek JB, Kirkpatrick AW: Emergent management of pelvic ring injuries: an update. / Can J Surg 2005, 48:49-6.
  12. Gansslen A, Pohlemann T, Krettek C: [A simple supraacetabular external fixation for pelvic ring fractures]. / Oper Orthop Traumatol 2005, 17:296-12. CrossRef
  13. Lindahl J, Hirvensalo E: Outcome of operatively treated type-C injuries of the pelvic ring. / Acta Orthop 2005, 76:667-78. CrossRef
  14. Olson SA, Pollak AN: Assessment of pelvic ring stability after injury. Indications for surgical stabilization. / Clin Orthop Relat Res 1996, 329:15-7. CrossRef
  15. Mason WT, Khan SN, James CL, Chesser TJ, Ward AJ: Complications of temporary and definitive external fixation of pelvic ring injuries. / Injury 2005, 36:599-04. CrossRef
  16. Kuttner M, Klaiber A, Lorenz T, Füchtmeier B, Neugebauer R: [The pelvic subcutaneous cross-over internal fixator]. / Unfallchirurg 2009, 112:661-69. CrossRef
  17. Gardner MJ, Mehta S, Mirza A, WM R: Anterior pelvic reduction and fixation using a subcutaneous internal fixator. / J Orthop Trauma 2012, 26:314-21. CrossRef
  18. Vaidya R, Colen R, Vigdorchik J, Tonnos F, Sethi A: Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation: initial clinical series. / J Orthop Trauma 2012, 26:1-. CrossRef
  19. Vaidya R, Oliphant B, Jain R, Nasr K, Siwiec R, Onwudiwe N, Sethi A: The bikini area and bikini line as a location for anterior subcutaneous pelvic fixation: An anatomic and clinical investigation. / Clin Anat 2013, 26:392-99. CrossRef
  20. Behrens F: General theory and principles of external fixation. / Clin Orthop Relat Res 1989, 241:15-3.
  21. Ota: Fracture and dislocation compendium. / J Orthop Trauma 1996, 10:71-5.
  22. Merriman DJ, Ricci WM, Mcandrew CM, Gardenr MJ: Is application of an internal anterior pelvic fixator anatomically feasible? / Clin Orthop Relat Res 2012, 470:2111-115. CrossRef
  23. Haidukewych GJ, Kumar S, Prpa B: Placement of half-pins for supra-acetabular external fixation: an anatomic study. / Clin Orthop Relat Res 2003, 411:269-73. CrossRef
  24. Vigdorchik JM, Esquivel AO, Jin X, Yang KH, Onwudiwe NA, Vaidya R: Biomechanical stability of a supra-acetabular pedicle screw Internal Fixation device (INFIX) vs External Fixation and plates for vertically unstable pelvic fractures. / J Orthop Surg Res 2012, 7:31. CrossRef
  25. Vaidya R, Kubiak EN, Bergin PF, Dombroski DG, Critchlow RJ, Sethi A, Starr AJ: Complications of anterior subcutaneous internal fixation for unstable pelvis fractures: a multicenter study. / Clin Orthop Relat Res 2012, 470:2124-131. CrossRef
  26. Burgess AR, Eastridge BJ, Young JW, Ellison TS, Ellison PS Jr, Poka A, Bathon GH, Brumback RJ: Pelvic ring disruptions: effective classification system and treatment protocols. / J Trauma 1990, 30:848-56. CrossRef
  
• 作者单位：Max J Scheyerer (20)
  Stefan M Zimmermann (20)
  Georg Osterhoff (20)
  Simon Tiziani (20)
  Hans-Peter Simmen (20)
  Guido A Wanner (20)
  Clèment ML Werner (20)
  
  20. Department of Surgery, Division of Trauma Surgery, University Hospital, Zurich, Switzerland
  
• ISSN：1756-0500

文摘

Background Fractures of the pelvic ring including disruption of the posterior elements in high-energy trauma have both high morbidity and mortality rates. For some injury pattern part of the initial resuscitation includes either external fixation or plate fixation to close the pelvic ring and decrease blood loss. In certain situations -especially when associated with abdominal trauma and the need to perform laparotomies -both techniques may put the patient at risk of either pintract or deep plate infections. We describe an operative approach to percutaneously close and stabilize the pelvic ring using spinal implants as an internal fixator and report the results in a small series of patients treated with this technique during the resuscitation phase. Findings Four patients were treated by subcutaneous placement of an internal fixator. Screw fixation was carried out by minimally invasive placement of two supra-acetabular iliac screws. Afterwards, a subcutaneous transfixation rod was inserted and attached to the screws after reduction of the pelvic ring. All patients were allowed to fully weight-bear. No losses of reduction or deep infections occurred. Fracture healing was uneventful in all cases. Conclusion Minimally invasive fixation is an alternative technique to stabilize the pelvic ring. The clinical results illustrate that this technique is able to achieve good results in terms of maintenance of reduction the pelvic ring. Also, abdominal surgeries no longer put the patient at risk of infected pins or plates.