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

Pan, Zhihong; Chen, Fancheng; Huang, Jian; Sun, Chengyi; Ding, Shenglong

doi:10.1186/s13018-021-02618-9

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…Despite the large number of anatomical and clinical studies on INFIX, there are no good measures to reduce the incidence of complications on the neurological side in the surgical operation of C-INFIX [29,30]. Moreover, the long span of the rod may lead to di culties in ensuring the quality of fracture repositioning [31].…”

Section: Disscusionmentioning

confidence: 99%

Clinical study of modified INFIX combined with sacroiliac joint screws for pelvic instable injuries

Zhao

Liu

et al. 2023

Preprint

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Objective The INFIX technique is becoming one of the most commonly performed surgical procedures for anterior pelvic ring instability injuries. The purpose of this article is to compare the clinical outcomes of modified anterior subcutaneous internal fixation (M-INFIX) with conventional anterior subcutaneous internal fixation (C-INFIX) for anterior pelvic ring instability injuries.Patients and Methods: A retrospective analysis of 36 cases of unstable pelvic injuries treated operatively at our institution, 20 of which were treated with conventional INFIX and 16 with modified INFIX. Data collected included age, gender, ISS score, fracture typing, operative time, operative bleeding, postoperative complications, fracture healing time, Matta score, Majeed score, and follow-up time. Statistical sub-folding of each variable between the two groups was performed.Results There was no statistical difference between the C-INFIX and M-INFIX groups in terms of age, gender, ISS score, follow-up time, fracture typing, fracture healing time, and Majeed score (P > 0.05). the M-INFIX had a significantly lower incidence of postoperative complications than the C-INFIX group, especially in the incidence of Lateral femoral cutaneous nerve (LFCN) injury (P < 0.05). In contrast, the M-INFIX group had statistically higher operative time, intraoperative bleeding, and Matta score than the C-INFIX group (P < 0.05).Conclusion This study was based on a modified application of the surgical experience with conventional INFIX and showed better clinical outcomes in terms of complication rates and quality of repositioning than the conventional surgical approach. These findings indicate that further analytical studies of this study would be valuable.

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Section: Disscusionmentioning

confidence: 99%

Clinical study of modified INFIX combined with sacroiliac joint screws for pelvic instable injuries

Zhao

Liu

et al. 2023

Preprint

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“…A review of the literature reveals that there have been finite element biomechanical studies of minimally invasive fixation of the anterior pelvic ring in recent years, but either the studies have been limited to Tile B pelvic fractures 9 , which are relatively stable, or they have focussed on modifications of minimally invasive internal fixation of the anterior ring 10 .…”

mentioning

confidence: 99%

Biomechanical comparative study on external fixators of new configurations in the treatment of Tile C pelvic injury

Zhao,

Ma,

et al. 2024

Sci Rep

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To compare the biomechanical properties of several anterior pelvic ring external fixators with two new configurations in the treatment of Tile C pelvic fractures, in order to evaluate the effectiveness of the new configurations and provide a reference for their clinical application. A finite element model of a Tile C pelvic ring injury (unilateral longitudinal sacral fracture and ipsilateral pubic fracture) was constructed. The pelvis was fixed with iliac crest external fixator (IC), anterior inferior iliac spine external fixator (AIIS), combination of IC and AIIS, combination of anterior superior iliac spine external fixator (ASIS) and AIIS, and S1 sacroiliac screw in 5 types of models. The stability indices of the anterior and posterior pelvic rings under vertical longitudinal load, left–right compression load and anterior–posterior shear load were quantified and compared. In the simulated bipedal standing position, the results of the vertical displacement of the midpoint on the upper surface of the sacrum are consistent with the displacement of the posterior rotation angle, and the order from largest to smallest is IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. The longitudinal displacement of IC is greater than that of the other models. The displacements of ASIS + AIIS and IC + AIIS are similar and the latter is smaller. In the simulated semi-recumbent position, the vertical displacement and posterior rotation angle displacement of the midpoint on the upper surface of the sacrum are also consistent, ranking from large to small: IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. Under the simulated left–right compression load state, the lateral displacements of the highest point of the lateral sacral fracture end are consistent with the highest point of the lateral pubic fracture end, and the order from large to small is S1 screw, IC, AIIS, ASIS + AIIS and IC + AIIS, among which the displacements of S1 screw and IC are larger, and the displacements of ASIS + AIIS and IC + AIIS are similar and smaller than those of other models. The displacements of IC + AIIS are smaller than those of ASIS + AIIS. Under the simulated anterior–posterior shear load condition, the posterior displacements of the highest point of the lateral sacral fracture end and the highest point of the lateral pubic fracture end are also consistent, ranking from large to small: IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. Among them, the displacements of IC and AIIS are larger. The displacements of ASIS + AIIS and IC + AIIS are similar and the latter are smaller. For the unstable pelvic injury represented by Tile C pelvic fracture, the biomechanical various stabilities of the combination of IC and AIIS are superior to those of the external fixators of conventional configurations. The biomechanical stabilities of the combination of ASIS and AIIS are also better than those of the external fixators of conventional configurations, and slightly worse than those of the combination of IC and AIIS. Compared with sacroiliac screw and conventional external fixators, the lateral stabilities of IC + AIIS and ASIS + AIIS are particularly prominent.

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Clinical study of modified INFIX combined with sacroiliac joint screws for pelvic instable injuries

Zhao,

Li,

Liu

et al. 2023

BMC Surg

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Objective The INFIX technique is becoming one of the most commonly performed surgical procedures for anterior pelvic ring instability injuries. The purpose of this article is to compare the clinical outcomes of modified anterior subcutaneous internal fixation (M-INFIX) with conventional anterior subcutaneous internal fixation (C-INFIX) for anterior pelvic ring instability injuries. Patients and methods A retrospective analysis of 36 cases of unstable pelvic injuries treated operatively at our institution, 20 of which were treated with C-INFIX and 16 with M-INFIX. Data collected included age, gender, ISS score, fracture typing, operative time, operative bleeding, postoperative complications, fracture healing time, Matta score, Majeed score, and follow-up time. Statistical sub-folding of each variable between the two groups was performed. Results There was no statistical difference between the C-INFIX and M-INFIX groups in terms of age, gender, ISS (Injury Severity Score), follow-up time, fracture typing, fracture healing time, and Majeed score (P > 0.05). the M-INFIX had a significantly lower incidence of postoperative complications than the C-INFIX group, especially in the incidence of Lateral femoral cutaneous nerve (LFCN) injury (P < 0.05). In contrast, the M-INFIX group had statistically higher operative time, intraoperative bleeding, and Matta score than the C-INFIX group (P < 0.05). Conclusion This study was based on a modified application of the surgical experience with C-INFIX and showed better clinical outcomes in terms of complication rates and quality of repositioning than the conventional surgical approach. These findings indicate that further analytical studies of this study would be valuable.

show abstract

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

Cited by 4 publications

References 27 publications

Clinical study of modified INFIX combined with sacroiliac joint screws for pelvic instable injuries

Clinical study of modified INFIX combined with sacroiliac joint screws for pelvic instable injuries

Biomechanical comparative study on external fixators of new configurations in the treatment of Tile C pelvic injury

Clinical study of modified INFIX combined with sacroiliac joint screws for pelvic instable injuries

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