Anterior Pelvic External Fixator Versus Subcutaneous Internal Fixator in the Treatment of Anterior Ring Pelvic Fractures

Cole, Peter A.; Gauger, Erich M.; Anavian, Jack; Ly, Thuan V.; Morgan, Robert; Heddings, Archie A.

doi:10.1097/bot.0b013e3182410577

Cited by 104 publications

(97 citation statements)

References 16 publications

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“…The first report on its technology, application, and on the initial clinical results was published in 2009 [15]. In the meantime, similar or slightly modified publications from other authors have become available [14,16]. The objective of this retrospective evaluation of cases was the initial collection of mid-to long-term clinical and radiological data.…”

Section: Introductionmentioning

confidence: 99%

“…Today, minimally invasive options have become available for this procedure, e.g. such as transpubic column screws [13] or interjectional reconstruction plates [14]. In our hospital, the anterior subcutaneous internal fixator (ASIF) has been developed for the stabilisation of unilateral and bilateral, transpubic pelvic fractures, and it has been routinely used since 2004.…”

Section: Introductionmentioning

confidence: 99%

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The anterior subcutaneous internal fixator (ASIF) for unstable pelvic ring fractures. Clinical and radiological mid-term results

Müller

Stosiek

Zellner

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to determine the outcome of unstable type C pelvic fractures treated with posterior stabilisation and the anterior subcutaneous internal fixator (ASIF). Methods Altogether, 36 consecutive patients were treated for unstable type C pelvic ring fractures using posterior stabilisation and ASIF. After a minimum of 18 months, the clinical and radiological outcome was retrospectively investigated. Results Overall, three patients (8.3 %) died, and 31 patients (86 %) were available for follow-up after a mean of 4.5 years. Thirty of 31 patients (97 %) showed radiographic bone consolidation of both the posterior and anterior pelvic ring. Only one non-union and two infections due to the anterior device were observed. The total German pelvic outcome score showed an excellent or good rating for 64.5 % of the patients, and a fair or poor for 35.5 %. The SF-12 questionnaire showed a significantly reduced total score for physical and mental health compared to a general reference population. Conclusions The ASIF represents an innovative surgical procedure for the treatment of type C pelvic ring fractures. In the medium term, patient satisfaction was high and the complication rate was low, despite the small number of patients. More cases must be investigated before the procedure can be recommended in general, possibly replacing the external fixator for the treatment of pelvic ring fractures in the future.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The anterior subcutaneous internal fixator (ASIF) for unstable pelvic ring fractures. Clinical and radiological mid-term results

Müller

Stosiek

Zellner

et al. 2013

International Orthopaedics (SICOT)

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“…There have been recent descriptions of treating pelvic ring injuries using minimally invasive techniques [2,6,13,31]. External fixation methods for pelvic ring injuries are well described [5,10,15,19,23,25,30].…”

Section: Introductionmentioning

confidence: 99%

“…Cole et al [2,16] recently described a new method in which subcutaneous plates are placed through small incisions over the ilium and fixed to the contralateral ilium or pubic symphysis or both. We termed these subcutaneous techniques of anterior pelvic internal fixation (APIF) ''the anterior pelvic bridge.''…”

Section: Introductionmentioning

confidence: 99%

“…Our early experience was reported in a retrospective comparative cohort investigation studying differences between the APIF technique and anterior pelvic external fixation (APEF) with anterior superior iliac spine (ASIS) pins for unstable pelvic ring injuries or plate placement in the case of APIF. In that study, 48 patients (24/group) with comparable demographic data and fracture patterns were reviewed for wound infections, ability to maintain fracture reduction, surgical site pain, and other complications [2]. One patient had a complication in the APIF group versus nine in the APEF group.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Technique: A Percutaneous Method of Subcutaneous Fixation for the Anterior Pelvic Ring: The Pelvic Bridge

Hiesterman

Hill

Cole

2012

Clinical Orthopaedics &Amp; Related Research

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Background Management of pelvic ring injuries using minimally invasive techniques may be desirable if reduction and stability can be achieved. We present a new technique, the anterior pelvic bridge, which is a percutaneous method of fixing the anterior pelvis through limited incisions over the iliac crest(s) and pubic symphysis. Description of Technique An incision is made over each anterior iliac crest and a 6-to 8-cm incision is centered over the symphysis. Either a locking reconstruction plate or a spinal rod is placed through a subcutaneous tunnel overlying the external oblique fascia in the subcutaneous tissue, and fixation into the iliac crest and pubis is achieved to effect stability. Methods A randomized controlled trial comparing anterior pelvic external fixation (APEF) versus anterior pelvic internal fixation (APIF) for unstable pelvic ring injuries was begun in October 2010. Patients with unstable pelvic ring injuries were enrolled and followed with respect to fracture reduction, surgical pain, complications, and functional outcome scores.

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Computer‐aided pelvic reduction frame for anatomical closed reduction of unstable pelvic fractures

Zhang

Zhao

et al. 2015

Journal Orthopaedic Research

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Traditional closed reductions of unstable pelvic fractures are mainly performed by surgeons using manual manipulation and subjective verification based on intra-operative roentgenography. It is difficult to perform an accurate closed reduction because of a lack of adequate knowledge of the displacement patterns and an inability to apply the reduction in correct direction. Using the concept of the remote center of motion mechanism and computer-aided design software, we developed a pelvic reduction frame for use in anatomical closed reductions of unstable pelvic fractures. With three-dimensional reconstruction technique and the matrix algorithm, the spatial orientation of the displaced hemipelvis can be calculated and deconstructed into several rotational and translational movements that can be completed with the frame. To verify the accuracy of this system, the rotations were repeated 10 times in arbitrary degrees and directions. After the matrix is calculated, the displaced hemipelvis can be reduced to the anatomical position using our frame. The maximum residual translational and rotational displacements were less than 5 mm and 4 degrees, which indicated the accuracy of this system. The maximum average residual translation and rotation were 1.87 mm in Z-axis (ranging: 4.63-0.1 mm) and 1.1 degrees around Y-axis (ranging: 3.81-0.13 degrees), respectively. Only the Z-axial translation showed a statistically significant difference (p < 0.05). In conclusion, the proposed pelvic reduction frame could be a useful tool for the anatomical reduction of unstable pelvic fractures. ß

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Anterior Pelvic External Fixator Versus Subcutaneous Internal Fixator in the Treatment of Anterior Ring Pelvic Fractures

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 104 publications

References 16 publications

The anterior subcutaneous internal fixator (ASIF) for unstable pelvic ring fractures. Clinical and radiological mid-term results

The anterior subcutaneous internal fixator (ASIF) for unstable pelvic ring fractures. Clinical and radiological mid-term results

Surgical Technique: A Percutaneous Method of Subcutaneous Fixation for the Anterior Pelvic Ring: The Pelvic Bridge

Computer‐aided pelvic reduction frame for anatomical closed reduction of unstable pelvic fractures

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