Comparison of percutaneous cross screw fixation versus open reduction and internal fixation for pelvic Day type II crescent fracture-dislocation: case-control study

Xiang, Guangheng; Dong, Xiaoyu; Jiang, Xi‐Fei; Cai, Leyi; Wang, Jianshun; Guo, Xiaoshan; Xiao, Jian; Feng, Yongzeng

doi:10.1186/s13018-020-02197-1

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…It is believed that the dislocation of crescent fractures primarily destroys rotational stability, but the stability in the vertical direction is barely affected 4,5 . However, recent research revealed that stability in the vertical direction may also be affected in crescent fractures, suggesting that the current understanding of crescent fracture dislocation is incomplete 17,18 . In our clinical work, we found five cases of this type of injury in the Day types 2 and 3 groups.…”

Section: Discussionmentioning

confidence: 59%

“…4,5 However, recent research revealed that stability in the vertical direction may also be affected in crescent fractures, suggesting that the current understanding of crescent fracture dislocation is incomplete. 17,18 In our clinical work, we found five cases of this type of injury in the Day types 2 and 3 groups. In these groups, the vertical displacement was >10 mm, and the posterior ring was completely unstable during the examination under anesthesia (EUA).…”

Section: Shortcomings Of Past Researchmentioning

confidence: 70%

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Lateral Compression Type 2 Pelvic Fractures—A Clinical Study of Fracture Displacement Measurement and Closed Reduction

Chen

Zhou³

et al. 2022

Orthopaedic Surgery

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Objective To evaluate the displacement in four lateral compression type 2 (LC2) fracture subtypes (iliac wing and three kinds of crescent fractures) and to investigate the appropriate closed reduction for treatment using a pelvic reduction frame. Methods A total of 71 patients with LC2 pelvic fractures from February 2014 to November 2019 were included in this retrospective cohort study. Preoperative X‐ray and computed tomography data were used to assess the direction of the fracture displacement and the sacroiliac joint dislocation. The fractures in all patients were reduced with a pelvic reduction frame and fixed with percutaneous screws as well as an anterior subcutaneous pelvic ring internal fixator. Two different closed reduction strategies were adopted, one was first longitudinal traction and then transverse traction, the other was first transverse traction then longitudinal and LC2 traction. The Matta score system was used to evaluate the postoperative X‐ray and the Majeed score system was used for follow‐up evaluation. Results A total of 13 iliac wing fractures (86.7%) and 16 Day type 1 fractures (94.1%) were vertically stable with only internal displacement, the ring width displacements were 5 (3, 8.75) and 8 (4, 12) mm, the posterior superior iliac spine (PSIS) differences were 0 (0, 0) mm and 0 (0, 0) mm. A total of 21 Day type 2 fractures (95.5%) and 16 Day type 3 fractures (94.1%) were characterized by cephalic and dorsal fracture dislocation on the basis of internal displacement, the ring width displacements were 6 (4.25, 12) and 4 (0, 7.5) mm and the PSIS differences were 4 (2, 5) and 0 (0, 3.75) mm. Based on the Matta scores, excellent reduction was achieved in 51 patients, good reduction in 17 patients, and poor reduction in three patients. The average Majeed score was 91.6, with a minimum outpatient follow‐up of 12 months (average 31.6 months). Conclusion LC2 fractures involve two different kinds of fracture displacement: internal displacement only and a combination of internal, cephalic, and dorsal dislocation through the sacroiliac joint. Good clinical outcomes can be achieved for LC2 fractures using two different closed reduction strategies.

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Section: Discussionmentioning

confidence: 59%

Section: Shortcomings Of Past Researchmentioning

confidence: 70%

Lateral Compression Type 2 Pelvic Fractures—A Clinical Study of Fracture Displacement Measurement and Closed Reduction

Chen

Zhou³

et al. 2022

Orthopaedic Surgery

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“…Starr [11] proposed a minimally invasive technique using cannulated LC-II screws to treat pelvic crescent fractures, which preserves the blood supply to the bone, reduces the incidence of a soft tissue injury, and decreases intraoperative blood loss. With the increasing popularity of minimally invasive techniques and the use of navigation devices such as the TiRobot [12,13], percutaneous cross-screw xation techniques have been widely applied in the clinical management of CFDP [14].…”

Section: Introductionmentioning

confidence: 99%

TiRobot-assisted modified sacroiliac screw combined with LC-II screw for dislocation of Day type II crescent fracture of the pelvis

Li,

Wang,

Guan

et al. 2023

Preprint

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Purpose To explore the clinical effect of modified sacroiliac screw and provide a new idea for the clinical treatment of Day type II crescent fracture of the pelvis. Methods We retrospectively analysed 42 patients undergoing surgical treatment for Day type II crescent fracture-dislocation from January 2020 to January 2023. TiRobot-assisted modified sacroiliac screws combined with LC-II screws was performed in 21 patients, and TiRobot-assisted traditional sacroiliac screws combined with LC-II screws was performed in other 21 patients. The patient characteristics, fracture classification, lengths of the iliac and sacral segments of the sacroiliac screws, distances between the sacroiliac screw entry point and the iliac fracture line, reduction quality, postoperative complications, and clinical outcomes were compared. Results There were no statistically significant differences between the two groups in terms of gender, age, cause of injury, fracture classification, time from injury to surgery, or intraoperative blood loss (P > 0.05). The average length of the iliac segment of sacroiliac screws in Group A was 3.71 ± 0.85 cm, which was longer than that in the control group (2.12 ± 0.47 cm, P < 0.01). The average length of the sacral segment for the sacroiliac screws in Group A and Group B was 5.65 ± 0.79 cm and 6.09 ± 0.70 cm, respectively, with no statistically significant difference (P = 0.066). The average distance between the sacroiliac screw entry point and the iliac fracture line in Group A was 3.31 ± 0.88 cm, which was longer than that in the control group (1.22 ± 0.64 cm, P < 0.01). The reduction quality in Group A was better than that in Group B (P < 0.05). There was no statistically significant difference in the Majeed score and incidence of postoperative complications at the final follow-up between the two groups. Conclusion TiRobot-assisted modified sacroiliac screws combined with LC-II screws is safe and effective in the treatment of Day type II crescent fracture-dislocations of the pelvis, it is worthwhile to be promoted in clinical treatment.

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Open reduction and internal fixation of crescent fracture-dislocation: anterior or posterior approach?

Ye,

Tang,

Shen

et al. 2024

Arch Orthop Trauma Surg

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Comparison of percutaneous cross screw fixation versus open reduction and internal fixation for pelvic Day type II crescent fracture-dislocation: case-control study

Cited by 4 publications

References 23 publications

Lateral Compression Type 2 Pelvic Fractures—A Clinical Study of Fracture Displacement Measurement and Closed Reduction

Lateral Compression Type 2 Pelvic Fractures—A Clinical Study of Fracture Displacement Measurement and Closed Reduction

TiRobot-assisted modified sacroiliac screw combined with LC-II screw for dislocation of Day type II crescent fracture of the pelvis

Open reduction and internal fixation of crescent fracture-dislocation: anterior or posterior approach?

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