Anterior Pelvic Subcutaneous Internal Fixator Application

Moazzam, Caroline; Heddings, Archie A.; Moodie, Patrick G.; Cole, Peter A.

doi:10.1097/bot.0b013e31823e6b82

Cited by 32 publications

(33 citation statements)

References 10 publications

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“…However, a cadaveric study on the proximity of these structures to a subcutaneously placed APIF found no risk to these anatomic structures in this technique (Fig. 3) [16]. Other possible unstudied disadvantages could include implant costs or increased surgical operating room time.…”

Section: Discussionmentioning

confidence: 95%

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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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Section: Discussionmentioning

confidence: 95%

“…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%

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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“…Hence, this modified three-point INFIX frame was thought to be more stable than the routine two-point INFIX frame for anterior pelvic ring injuries. As with the pelvic bridge, no damage was incurred on any fascia or muscle in the Pfannenstiel incision because the screws were directly positioned over the tubercles where the rectus tendons attach [13], which minimized the risk of ilioinguinal and iliohypogastric neuropathy. The additional Pfannenstiel incision was also used to create a subcutaneous corridor to bilateral AIIS as is done in the pelvic bridge for bilateral pubic ramus fractures.…”

Section: Discussionmentioning

confidence: 99%

Modified pedicle screw–rod fixation as a minimally invasive treatment for anterior pelvic ring injuries: an initial case series

Wu¹,

Liu²,

Fu³

et al. 2017

J Orthop Surg Res

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BackgroundUnstable pelvic ring injuries often involve high mortality and morbidity. This study was aimed to evaluate the modified minimally invasive pedicle screw–rod fixation for anterior pelvic ring injuries, in the respects of its feasibility, merits, and limitations.MethodsTwenty-three patients with unstable pelvic ring injuries underwent the modified anterior pedicle screw–rod fixation, with or without posterior fixation. The clinical outcomes were assessed using Majeed scores, and the quality of reduction was evaluated according to the criteria of Matta.ResultsMajeed scores showed that the clinical outcomes at postoperatively 1 year were excellent in 14 patients, good in 7, and fair in 2. One woman complained of persistent pain at the pubic tubercle during sexual intercourse. Iatrogenic neuropraxia of the unilateral lateral femoral cutaneous nerve occurred in 3 patients. Unilateral femoral nerve palsy occurred in 1 patient. The reduction was found to be excellent in 12 patients, good in 8, and fair in 3. Heterotopic ossification occurred in 8 patients, all being asymptomatic.ConclusionsThe modified pedicle screw–rod fixation with the minimally invasive technique offered an effective alternative for unstable anterior pelvic ring injuries.

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“…By cutting rectus abdominis muscle at the vertical center of the inferior belly, the pelvic structure was sufficiently exposed so that the operative field was much clearer [13, 14]. Although the “Stoppa” approach is superior to the ilioinguinal approach, some complications could still happen, including peritoneal perforation, vascular nerve injury, deep vein thrombosis, pulmonary embolism, inguinal hernia, incision infection, and traumatic arthritis [15]. Hence, the application of this approach is very limited because of possible trauma and complications.…”

Section: Discussionmentioning

confidence: 99%

“…Cole et al used the percutaneous anterior pelvic bridge to deal with the fracture of the pelvic anterior ring in 2012 [15, 16]. The operation made incision over the iliac crest and the pubic bone, inserting a plate from a subcutaneous channel upon the inguinal ligament, and then screws were fixed on the iliac crest and the tuberculum pubicum.…”

Section: Discussionmentioning

confidence: 99%

Numerical Investigation on the Biomechanical Performance of Laparoscopic-Assisted Plate Used for Fixing Pelvic Anterior Ring Fracture

Lyu

Yin

et al. 2017

Journal of Healthcare Engineering

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Because of the minimal soft tissue injury, the laparoscopic-assisted internal fixation is a promising technique in fixing the pelvic anterior ring fracture. The aim of this study was to investigate the biomechanical performance of the laparoscopic-assisted plate by the finite element method. Four kinds of implants were investigated, that is, the laparoscopic-assisted plate (LAP), the percutaneous anterior pelvic bridge (PAPB), the transramus intraosseous screw (TIS), and the open reduction (OR). The stability of the implants was investigated under three loading cases, showing that when the LAP was used, the stress at the fracture site was smaller than that at other parts, while for other implants, the high stress was always around the fracture site. In conclusion, the LAP demonstrated a good biomechanical performance in fixing the pelvic anterior ring fracture and is a promising technique in clinical applications.

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Anterior Pelvic Subcutaneous Internal Fixator Application

Cited by 32 publications

References 10 publications

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

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

Modified pedicle screw–rod fixation as a minimally invasive treatment for anterior pelvic ring injuries: an initial case series

Numerical Investigation on the Biomechanical Performance of Laparoscopic-Assisted Plate Used for Fixing Pelvic Anterior Ring Fracture

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