Modified less invasive anterior subcutaneous fixator for unstable Tile-C-pelvic ring fractures: a biomechanical study

Becker, C.; Kammerlander, Christian; Kußmaul, Adrian Cavalcanti; Woiczinski, Matthias; Thorwächter, Christoph; Zeckey, Christian; Sommer, Fabian; Linhart, Christoph; Weidert, Simon; Suero, Eduardo M.; Böcker, Wolfgang; Greiner, Andreas

doi:10.1186/s12938-019-0648-z

Cited by 15 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, modifications of INFIX application viz, unilateral, and extended unilateral INFIX was compared to that of bilateral and extended bilateral INFIX devices in a biomechanical study. 78 The stability of unilateral INFIX was found to be significantly improved by additional application of pubic ramus screws (extended unilateral INFIX) and was suggested to be a feasible alternative.…”

Section: Primary Internal Fixation In Pelvic Fractures With Hemodynamic Instabilitymentioning

confidence: 99%

Management of pelvic injuries in hemodynamically unstable polytrauma patients – Challenges and current updates

Perumal

et al. 2021

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

Pelvic injuries are notorious for causing rapid exsanguination, and also due to concomitant injuries and complications, they have a relatively higher mortality rate. Management of pelvic fractures in hemodynamically unstable patients is a challenging task and has been variably approached. Over the years, various concepts have evolved, and different guidelines and protocols were established in regional trauma care centers based mainly on their previous experience, outcomes, and availability of resources. More recently, damage control resuscitation, pelvic angioembolization, and acute definitive internal fixation are being employed in the management of these unstable injuries, without clear consensus or guidelines. In this background, we have performed a computerized search using the Cochrane Database of Systematic Reviews, Scopus, Embase, Web of Science, and PubMed databases on studies published over the past 30 years. This comprehensive review aims to consolidate available literature on the current epidemiology, diagnostics, resuscitation, and management options of pelvic fractures in polytraumatized patients with hemodynamic instability with particular focus on damage control resuscitation, pelvic angioembolization, and acute definitive internal fixation.

show abstract

Section: Primary Internal Fixation In Pelvic Fractures With Hemodynamic Instabilitymentioning

confidence: 99%

Management of pelvic injuries in hemodynamically unstable polytrauma patients – Challenges and current updates

Perumal

et al. 2021

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

show abstract

“…MPSRF combines the advantages of INFIX and pelvic bridging. The safety and efficacy of minimally invasive fixation of pelvic fractures have been demonstrated by several anatomical and clinical studies, although fixation stability remains a concern [ 20 , 21 ]. Additionally, few studies have investigated whether these two fixation techniques lead to sufficiently strong implants and adequate biomechanical reduction.…”

Section: Discussionmentioning

confidence: 99%

Modified pedicle screw-rod versus anterior subcutaneous internal pelvic fixation for unstable anterior pelvic ring fracture: a retrospective study and finite element analysis

Pan¹,

Chen

Huang

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

Objectives This study compared the stability and clinical outcomes of modified pedicle screw-rod fixation (MPSRF) and anterior subcutaneous internal pelvic fixation (INFIX) for the treatment of anterior pelvic ring fractures using the Tornetta and Matta grading system and finite element analyses (FEA). Methods In a retrospective review of a consecutive patient series, 63 patients with Orthopaedic Trauma Association (OTA)/Arbeitsgemeinschaft für Osteosynthesefragen (AO) type B or C pelvic ring fractures were treated by MPRSF (n = 30) or INFIX (n = 33). The main outcome measures were the Majeed score, incidence of complications, and adverse outcomes, and fixation stability as evaluated by finite element analysis. Results Sixty-three patients were included in the study, with an average age of 34.4 and 36.2 in modified group and conventional group, respectively. Two groups did not differ in terms of the injury severity score, OTA classification, cause of injury, and time to pelvic surgery. However, the MPSRF group had a rate of higher satisfactory results according to the Tornetta and Matta grading system than the conventional group (73.33% vs 63.63%) as well as a higher Majeed score (81.5 ± 10.4 vs 76.3 ± 11.2), and these differences were statistically significant at 6 months post-surgery. FEA showed that MPSRF was stiffer and more stable than INFIX and had a lower risk of implant failure. Conclusions Both MPSRF and INFIX provide acceptable biomechanical stability for the treatment of unstable anterior pelvic ring fractures. However, MPSRF provides better fixation stability and a lower risk of implant failure, and can thus lead to better clinical outcomes. Therefore, MPSRF should be more widely applied to anterior pelvic ring fractures

show abstract

“…Therefore, INFIX is generally combined with a posterior fixation for pelvic ring injury [ 6 ]. Although modified INFIX has been reported to make stability of the pelvic ring stronger than that of INFIX [ 11 , 12 ], modified INFIX requires a subcutaneous rod to pass near the pubis because modified INFIX requires screw insertion into the pubis. Therefore, the flexibility of the subcutaneous rod path is low.…”

Section: Discussionmentioning

confidence: 99%

Treatment of unstable pelvic ring injury with a dual internal anterior subcutaneous fixator using spinal instrumentation called “dual INFIX”: A Case Report

Sasagawa¹

2021

JOCR

View full text Add to dashboard Cite

Introduction: External fixation, various subcutaneous screw fixations, and plate fixation can be considered as fixation methods for unstable pelvic ring fractures. We describe a first case of treated unstable pelvic ring injury using a dual internal anterior subcutaneous fixator we called “dual INFIX,” comprising four screws, two subcutaneous rods, and two cross-link connectors, without posterior fixation. Case Report: An 81-year-old man sustained an unstable pelvic injury (AO type B2) with fracture of the left ilium and pubis. Dual INFIX was used to stabilize the pelvic ring injury. Polyaxial screws were introduced along a path between the anterior inferior iliac spine and ipsilateral posterior superior iliac spine until the head of the screw lay immediately above the fascia. Bilateral cranial screws were connected by a rod passed subcutaneously, and caudal screws were connected by the other rod. Finally, cross-link connectors connected cranial and caudal rods on the right and left. One year after the first operation, the patient could walk without a cane and had no limitation of daily living and bony fusion was achieved. Conclusion: The stability of the pelvic ring of dual INFIX was sufficient to achieve bony fusion in this case. The stability of dual INFIX should be stronger than that of INFIX. Dual INFIX as with INFIX has other advantages such as ease of management compared with external fixation, and nonnecessity of strict anatomical reduction compared with various percutaneous screw fixation. Furthermore, this technique is simple and minimally invasive compared with plate fixation because it does not require open surgery. However, because the type C fracture with an unacceptable position of reduction by closed reduction has the possibility to become a symptomatic malunion, such cases should not be treated by this method. Furthermore, it is necessary for pelvic stabilization using dual INFIX that the contralateral pelvis is intact because dual INFIX stabilizes

show abstract

Modified less invasive anterior subcutaneous fixator for unstable Tile-C-pelvic ring fractures: a biomechanical study

Cited by 15 publications

References 19 publications

Management of pelvic injuries in hemodynamically unstable polytrauma patients – Challenges and current updates

Management of pelvic injuries in hemodynamically unstable polytrauma patients – Challenges and current updates

Modified pedicle screw-rod versus anterior subcutaneous internal pelvic fixation for unstable anterior pelvic ring fracture: a retrospective study and finite element analysis

Treatment of unstable pelvic ring injury with a dual internal anterior subcutaneous fixator using spinal instrumentation called “dual INFIX”: A Case Report

Contact Info

Product

Resources

About