To Study the Clinical and Radiological Result of Per-Cutaneous Fixation of Pelvic and Acetabular Fractures: A Minimally Invasive Internal Fixation Technique
Vipin Tyagi, Rahul Kakran*, Ashish Kumar Agarwal, Pankaj Agarwal, Alok Tripathi and Saurabh Maheshwari
Department of Orthopaedics, Yashoda Hospital, Nehru Nagar, Ghaziabad, U.P., India
*Corresponding Author: Rahul Kakran, Department of Orthopaedics, Yashoda Hospital, Nehru Nagar, Ghaziabad, U.P., India.
May 15, 2023; Published: August 11, 2023
Introduction: The pelvic ring fractures and acetabular fractures are among the major orthopedic injuries associated with high rates of morbidity and mortality. Open surgical stabilization is the standard treatment for the majority of these complications. Percutaneous minimally invasive surgical stabilization of the fractures has become an accepted treatment method for the past several years. This study investigated the outcomes of percutaneous fixation of pelvic and acetabular fractures.
Aims and objectives: To evaluate the efficacy of Percutaneous Fixation of Pelvic and Acetabular Fractures by analyzing clinical and radiological outcomes using Merle’s hip score and Matta’s criteria respectively and also assess the pre and post operative complications of Percutaneous fixation.
Method: In this Ambispective observational study, we included 8 patients with pelvis and acetabular injuries who needed percutaneous fixation as per the Indications. The patients were selected according to the inclusion and exclusion criteria. The patients were operated between 2022 and 2023 at Yashoda Superspeciality Hospital, Nehru Nagar, Ghaziabad.
Result: Follow up of total 8 patients was done. The patients were assessed clinically according to the Merle’s Hip
Score and radiologically according to Matta’s criteria.
Out of the 8 patients included in this study, 2 patients had excellent result, 5 patients had good result and 1 patient had fair result who developed paresthesia (treated with percutaneous screw removal), as per Merle’s Hip score. And 5 patients had excellent result, 2 patients had good result and 1 patient had fair result and anatomical reduction was achieved in 7 patients and imperfect reduction was achieved in 1 patient as per Matta’s criteria.
Conclusion: Closed reduction and percutaneous minimally invasive screw fixation for a pelvic or acetabular Fractures is a useful surgical treatment option with low complication rates.
Keywords: Pelvis; Acetabulum; Fracture; Percutaneous Fixation; Merle’s Hip Score; Matta’s Criteria
- Zhao JX., et al. “Early experience with reduction of unstable pelvic fracture using a computer-aided reduction frame”. BioMed Research International 1 (2018): 7297635.
- Yoshihara H and Yoneoka D. “Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality”. Journal of Trauma and Acute Care Surgery 2 (2014): 380-385.
- Grubor P., et al. “Controversies in treatment of acetabular fracture”. Medical Archives 1 (2015): 16-20.
- Vallier HA., et al. “Early definitive stabilization of unstable pelvis and acetabulum fractures reduces morbidity”. Journal of Trauma 3 (2010): 677-684.
- Schweitzer D., et al. “Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures”. Injury8 (2008): 869-874.
- Boudissa M., et al. “Epidemiology and treatment of acetabular fractures in a level-1 trauma centre: retrospective study of 414 patients over 10 years”. Orthopaedics and Traumatology: Surgery and Research 3 (2017): 335-339.
- Elzohairy MM and Salama AM. “Open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable posterior pelvic ring disruptions”. Orthopaedics and Traumatology: Surgery and Research 2 (2017): 223.
- Neal B., et al. “Incidence of heterotopic bone formation after major hip surgery”. ANZ Journal of Surgery 11 (2002): 808-821
- Routt MC., et al. “Percutaneous iliosacral screws with the patient supine technique”. Operative Techniques in Orthopaedics 1 (1993): 35-45.
- Lin YC., et al. “Percutaneous antegrade screwing for anterior column fracture of acetabulum with fluoroscopic-based computerized navigation”. Archives of Orthopaedic and Trauma Surgery 2 (2008): 223-226.
- Mullis BH and Sagi HC. “Minimum 1-year follow-up for patients with vertical shear sacroiliac joint dislocations treated with iliosacral screws: does joint ankylosis or anatomic reduction contribute to functional outcome?” Journal of Orthopaedic Trauma 5 (2008): 293-298.
- Caviglia H., et al. “Percutaneous fixation of acetabular fractures”. EFORT Open Reviews 5 (2018): 326-334.
- Chui KH., et al. “Three-dimensional navigation-guided percutaneous screw fixation for nondisplaced and displaced pelvi-acetabular fractures in a major trauma centre”. International Orthopaedics 6 (2018): 1387-1395.
- Eckardt H., et al. “Good functional outcome in patients suffering fragility fractures of the pelvis treated with percutaneous screw stabilisation: assessment of complications and factors influencing failure”. Injury 12 (2017): 2717-2723.
- Karabila MA., et al. “Surgical management of sacroiliac joint lesions in unstable pelvic ring fractures using percutaneous iliosacral screw fixation”. The Pan African Medical Journal 1 (2016): 168.
- Krishnan BH., et al. “A retrospective analysis of percutaneous SI joint fixation in unstable pelvic fractures: Our experience in armed forces”. Medical Journal Armed Forces India 3 (2016): 231-235.
- Tempelaere C., et al. “Percutaneous posterior fixation for unstable pelvic ring fractures”. Orthopaedics and Traumatology: Surgery and Research 8 (2017): 1169-1171.
- Green DP., et al. “Fractures in adults”. 6th Philadelphia: Lippincott Williams and Wilkins (2006).
- Mouhsine E., et al. “Percutaneous retrograde screwing for stabilisation of acetabular fractures”. Injury 11 (2005): 1330-1336.
- Cole JD., et al. “Outcome after fixation of unstable posterior pelvic ring injuries”. Clinical Orthopaedics and Related Research 1 (1996): 160-179.
- Keating JF., et al. “Early fixation of the vertically unstable pelvis: the role of iliosacral screw fixation of the posterior lesion”. Journal of Orthopaedic Trauma 2 (1999): 107-113.
- Routt ML Jr., et al. “Percutaneous fixation of pelvic ring disruptions”. Clinical Orthopaedics and Related Research 375 (1 (2000): 15-29.
- Fang C., et al. “Complications after percutaneous internal fixator for anterior pelvic ring injuries”. International Orthopaedics 9 (2018): 1785-1790.
- Papakostidis C., et al. “Pelvic ringdisruptions: treatment modalities and analysis of outcomes”. International Orthopaedics 2 (2009): 329-338.
- Oh CW., et al. “Anterior plating and percutaneous iliosacral screwing in an unstable pelvic ring injury”. Journal of Orthopaedic Science 2 (2008): 107-115.
- Collinge C., et al. “Standard multiplanar fluoroscopy versus a fluoroscopically based navigation system for the percutaneous insertion of iliosacral screws: a cadaver model”. Journal of Orthopaedic Trauma 4 (2005): 254-258.
- Lee CH., et al. “Biomechanical study of different fixation techniques for the treatment of sacroiliac joint injuries using finite element analyses and biomechanical tests”. Computers in Biology and Medicine 1 (2017): 250-257.
- Qoreishi M., et al. “Clinical Results of Percutaneous Fixation of Pelvic and Acetabular Fractures: A Minimally Invasive Internal Fixation Technique”. The Archives of Bone and Joint Surgery 3 (2019): 284-290.