Early Experience with Reduction of Unstable Pelvic Fracture Using a Computer-Aided Reduction Frame

Zhao, Jing-Xin; Zhang, Lihai; Su, Xiuyun; Zhao, Zhe; Zhao, Yanpeng; Sun, Guofei; Tang, Peifu

doi:10.1155/2018/7297635

Cited by 15 publications

(12 citation statements)

References 29 publications

(35 reference statements)

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“…A tremendous amount of caudad traction via transcondylar traction is required to reduce the cranially displaced posterior ring, but there are no good methods to resist this transcondylar traction 3, 5–8 . Several tools were developed to resist the transcondylar traction, including Matta frame 9 , Starr frame 10–12 , percutaneous Schantz screw in the greater trochanter 2 , and femoral distractor 4, 13 . However, when used with these tools, current closed reduction techniques have difficulties in achieving complete or nearly anatomical reduction of irreducible UVDPRD because hematoma maturation and soft tissue fibrosis often develop, which likely increase the risk of failed closed reduction of irreducible UVDPRD 4, 5, 8, 14 .…”

Section: Introductionmentioning

confidence: 99%

Achieve Closed Reduction of Irreducible, Unilateral Vertically Displaced Pelvic Ring Disruption with an Unlocking Closed Reduction Technique

Chen

Zhao

et al. 2021

Orthopaedic Surgery

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Objective To be able to treat irreducible unilateral vertically displaced pelvic ring disruption (UVDPRD) using closed reduction, we introduced a technique named Unlocking Closed Reduction Technique (UCRT) and evaluated its effectiveness with improved pelvic closed reduction system (PCRS). Methods A retrospective study was performed in our department. Between January 2014 and December 2017, 43 patients whose UVDPRD were not successfully reduced using transcondylar traction. Subsequently, they were treated with UCRT using improved PCRS. The study included 19 male and 24 female patients, with a mean age at the time of the operation of 46.2 years. During surgery, operation time and blood loss were recorded. Post‐surgical reduction quality was evaluated using Matta scoring criteria and patient lower‐extremity functional outcome was evaluated using Majeed functional scoring criteria. Results When used with improved PCRS, UCRT achieved pelvic reduction in all 43 cases of irreducible UVDPRD with postoperative pelvic reduction quality rated excellent and good for 42/43 (97.6%) patients according to the Matta scoring criteria (Matta Score < 10 mm). While no post‐surgical complications emerged as the direct result of UCRT in this cohort of patients, 8/37 patients who were treated with subcutaneous supra‐acetabular pedicle screw internal fixation (INFIX) for anterior ring fixation developed lateral femoral cutaneous nerve injury but recovered 6 months postoperatively. No revision surgery was performed on any of the recruited patients. All patients' lower‐extremity functionality was rated excellent with an average Majeed function score of 94.3 during the last follow‐up at an average of 41.6 months postoperatively. Conclusion With excellent surgical and functional outcomes in patients with irreducible UVDPRD, improved PCRS‐assisted UCRT proved to be a safe and effective method for the treatment of irreducible UVDPRD.

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Section: Introductionmentioning

confidence: 99%

Achieve Closed Reduction of Irreducible, Unilateral Vertically Displaced Pelvic Ring Disruption with an Unlocking Closed Reduction Technique

Chen

Zhao

et al. 2021

Orthopaedic Surgery

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“…With the promotion and popularization of early emergency treatment and reconstruction techniques for pelvic fractures, the success rate concerning early management of pelvic fractures has prominently improved, and most displaced unstable pelvic fractures can be reduced and xed early [10]. However, some severe pelvic fractures do not qualify for early reconstruction due to the need for early rescue for life-threatening massive bleeding and associated injuries [3,11].…”

Section: Discussionmentioning

confidence: 99%

Sacral Osteotomy Combined With Lumbopelvic Distraction Osteosynthesis in the Treatment of Malunion or Nonunion of Vertically Displaced Pelvic Fractures

Luo

et al. 2021

Preprint

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Background Malunion or nonunion of vertically displaced pelvic fractures resulting in lower limb length discrepancies, claudication, and pain. There have been few previous reports of this type of corrective surgery of the old pelvis. We present a new surgical technique of sacral osteotomy combined with lumbopelvic distraction osteosynthesis (LPDO) in the treatment of malunion and nonunion of vertically displaced pelvic fractures and report on its short-term clinical results.Methods We retrospectively reviewed nine patients (five males and four females) with malunion or nonunion of vertically displaced pelvic fractures treated with sacral osteotomy and LPDO from April 2015 to January 2020. The age ranged from 14 to 45 years (average, 30.7 years). The time from injury to deformity correction surgery ranged from 3 months to 5 years (average, 12.8 months). The vertical displacement of a unilateral pelvis was 3.0-4.5 cm (average, 3.80 cm). According to the AO/OTA classification at initial pelvic fracture, eight cases were type C1.3 and one case were type C3.3. Sacral osteotomy and LPDO were used in all nine patients. The degree of unilateral pelvic reduction was assessed postoperatively based on measurements from the anteroposterior (AP) X-ray. The Majeed score and pain visual analog scale (VAS) score were used to assess the therapeutic effect of the patients during follow-up.Results In all nine patients, postoperative AP X-ray showed correction displacement of 1.7-3.9 cm (average, 3.20 cm). All the patients were followed up for 6 to 36 months (average, 12.7 months). At the last follow-up, the Majeed score of pelvic fracture increased from an average of 53.9 points (30-84 points) preoperatively to 87.0 points (72-94 points), and the VAS score for pain decreased from an average of 6.0 points (4-8 points) preoperatively to 1.2 points (0-3 points). None of the patients had complications, such as infection, implant broken, screw loosening, iatrogenic nerve, or blood vessel injury. Conclusion Sacral osteotomy combined with LPDO for the treatment of pelvic malunion or nonunion caused by sacral fracture can correct significantly vertical displacement of a unilateral pelvis, prolong limb length, and reconstruct the stability of a pelvic ring, leading to good clinical results.

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“…For stable pelvic fractures, most doctors mainly adopt conservative treatment, including reduction through suspension traction, femoral supracondylar traction and lateral lying [3]. For unstable pelvic fractures, commonly methods of pelvic fracture reduction include external fixator therapy [4][5][6][7], open reduction and internal fixation [8], and percutaneous minimally invasive screw internal fixation [9]. With the development of medical robot technology, pelvic fracture reduction robot began to be applied in pelvic fracture reduction surgery [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Analysis on circumpelvic muscle force and spatial position and orientation of bone traction needle for pelvic fracture reduction

Lei¹,

Li²,

Xu³

et al. 2021

J. vibroeng.

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Robot-assisted reduction of pelvic fracture, the bone traction needles need to be inserted into the iliac bone of the affected pelvis, and the clamping instrument of the robot is connected to the bone traction needle. The biomechanical characteristics of the pelvic musculoskeletal tissues are different with the different spatial position and orientation of the bone traction needle. In this paper, a new PA-MTM model considering the pinnate angle of skeletal muscle is proposed to analyze the muscle force of skeletal muscle. According to the planned reduction path, reduction force during the reduction process is calculated. Based on the pelvic CT scan data and the muscle distribution of the pelvis, the musculoskeletal model of the fractured pelvis is reconstructed. Then, the finite element model of the pelvic musculoskeletal tissue with bone traction needle is established. The maximum reduction force is applied on the bone traction needles, and the stress distribution of the pelvic musculoskeletal tissue with the needles in different spatial position and orientation is comparatively studied. The results show that the suitable force point on bone traction needle is S1 point. When the bone traction needle is inserted into the iliac crest and the anterior inferior iliac spine, the pelvis is in a good stress state.

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Early Experience with Reduction of Unstable Pelvic Fracture Using a Computer-Aided Reduction Frame

Cited by 15 publications

References 29 publications

Achieve Closed Reduction of Irreducible, Unilateral Vertically Displaced Pelvic Ring Disruption with an Unlocking Closed Reduction Technique

Achieve Closed Reduction of Irreducible, Unilateral Vertically Displaced Pelvic Ring Disruption with an Unlocking Closed Reduction Technique

Sacral Osteotomy Combined With Lumbopelvic Distraction Osteosynthesis in the Treatment of Malunion or Nonunion of Vertically Displaced Pelvic Fractures

Analysis on circumpelvic muscle force and spatial position and orientation of bone traction needle for pelvic fracture reduction

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