Objective To examine the surgical techniques and preliminary outcomes of the lateral rectus approach (LRA) for treating vertical shear ( VS ) pelvic fracture associated with lumbosacral plexus (LSP) injury. Methods This study was a retrospective trial. From August 2010 to October 2017, 29 patients with VS pelvic fractures involving LSP injury who were treated with the LRA were included in this study. The patients were 18–61 years old, with a mean age of 36.2 years. All patients underwent neurolysis, open reduction, and internal fixation (ORIF) through the LRA. The fracture reduction was evaluated using the Matta criteria, and the neural recovery was evaluated by muscle strength grading proposed by the British Medical Research Council (BMRC). Results All 29 patients underwent the surgery successfully. The mean operating time was 155.2 ± 32.1 min (range: 105–220 min). The mean operative blood loss was 1021.4 ± 363.4 mL (range: 400–2000 mL). All patients were followed‐up for at least 24 months (mean, 32.8 ± 13.5 months; range: 24–96 months). According to the Matta criteria, there were 17 excellent cases, nine good cases, and three fair cases in 29 patients. The ratio of excellent‐to‐good cases was 89.66%. According to the criteria of the Nerve Injuries Committee of the British Medical Research Council (BMRC), the recovery of nerve and muscle strength achieved to M5 (full recovery of neurological symptoms) was 14 cases, M4 (fine recovery of neurological symptoms), seven cases; M1, M2, and M3 (partial recovery of neurological symptoms), five cases, and M0 (no recovery of neurological symptoms), three cases. Conclusions LRA is a safe and feasible surgical approach for treating VS pelvic fractures with LSP injury, which can be used to perform nerve exploration and release from the front, reduce the fracture, and fix it with the anterior iliac plates and/or sacroiliac screws.

Objectives This study aimed to investigate the symmetry of the Chinese pelvis. Methods Computed tomography scan images of each of 50 Chinese pelvises were converted to 3D models and the left sides of the pelvises were reflected on Mimics software. Then, the reflected left side model was aligned with the right side using the closest point algorithm function of Geomagic software to perform symmetry analysis. The volume and surface area of either side of the pelvises were also calculated. The mean standard deviation (SD), the mean percentage of permissible deviations within the ±2 mm range, the percentage differences in volume and surface area were measured to compare pelvic symmetry. In addition, the distribution of pelvic bilateral symmetry associated with both age and sex were compared. Results The mean SD was 1.15 ± 0.16 mm and the mean percentage of permissible deviations was 90.82% ± 4.67%. The deviation color maps showed that the specific areas of asymmetry were primarily localized to major muscle or ligament attachment sites and the sacroiliac joint surfaces. There was no significant difference between the bilateral sides of the pelvis in either volume or surface area. Additionally, no difference in any indexes was exhibited in relation to sex and age distribution. Conclusion Our results demonstrated that the pelvis has high bilateral symmetry, which confirmed the potential of using contralateral pelvic models to create fully patient‐specific and custom‐made pelvic implants applicable for the treatment of fracture and bony destruction.