Minimally Invasive Lumbopelvic Fixation for Stabilization of the Posterior Pelvic Ring in Victims With Polytrauma

Abstract

Objective. To evaluate the use of minimally invasive lumbopelvic fixation (LPF) in the acute period of traumatic disease in patients with vertically unstable pelvic injuries. Material and Methods. Three patients with vertically unstable injuries of the pelvic ring were operated on using LPF technique. Fixation of pelvic fractures was performed by a minimally invasive procedure with a system of transpedicular and iliosacral screws. The choice of the lumbopelvic system configuration depended on the sacral injury morphology. Results. The average length of hospital stay was 22.7 ± 7.5 days. Assessment of the functional status of the pelvis using Majeed scale was 92.0 ± 5.3 points. Before surgery, the neurological status was assessed by Gibbons scale, all victims received 1 point: decompression of sacral neural structures was not indicated. All the victims returned to the previous level of physical and professional activity in the period from 6 to 18 months. At the same time, control SCT of the pelvis was performed, which confirmed the union of pelvic fractures and the stability of instrumentation. Conclusion. Successful restoration of the pelvic ring anatomy with subsequent stable fixation using minimally invasive internal osteosynthesis in the acute period of traumatic disease including lumbopelvic transpedicular stabilization allowed obtaining good anatomical and functional outcomes in patients with vertically unstable injuries of the pelvic ring.