Perioperative management of acetabular and pelvic fractures: evidence-based recommendations

Yakkanti, Ramakanth; Mohile, Neil; Cohen-Levy, Wayne B.; Haziza, Sagie; Lavelle, Michael T.; Bellam, Krishna; Quinnan, Stephen M.

doi:10.1007/s00402-021-04278-0

Cited by 6 publications

(1 citation statement)

References 132 publications

(166 reference statements)

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“…In addition to this, the evidence-based recommendations published in 2021 on the perioperative management of acetabular and pelvic fractures also mention that IVCF cannot be routinely applied prophylactically in patients with pelvic and acetabular fractures, but can be considered in preoperative high-risk groups ( Yakkanti et al, 2021 ).…”

Section: Ivcf For Orthopaedic Management Of Vtementioning

confidence: 99%

The application of inferior vena cava filters in orthopaedics and current research advances

Wang

Zhou

et al. 2022

Front. Bioeng. Biotechnol.

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Deep vein thrombosis is a common clinical peripheral vascular disease that occurs frequently in orthopaedic patients and may lead to pulmonary embolism (PE) if the thrombus is dislodged. pulmonary embolism can be prevented by placing an inferior vena cava filter (IVCF) to intercept the dislodged thrombus. Thus, IVCFs play an important role in orthopaedics. However, the occurrence of complications after inferior vena cava filter placement, particularly recurrent thromboembolism, makes it necessary to carefully assess the risk-benefit of filter placement. There is no accepted statement as to whether IVCF should be placed in orthopaedic patients. Based on the problems currently displayed in the use of IVCFs, an ideal IVCF is proposed that does not affect the vessel wall and haemodynamics and intercepts thrombi well. The biodegradable filters that currently exist come close to the description of an ideal filter that can reduce the occurrence of various complications. Currently available biodegradable IVCFs consist of various organic polymeric materials. Biodegradable metals have shown good performance in making biodegradable IVCFs. However, among the available experimental studies on degradable filters, there are no experimental studies on filters made of degradable metals. This article reviews the use of IVCFs in orthopaedics, the current status of filters and the progress of research into biodegradable vena cava filters and suggests possible future developments based on the published literature by an electronic search of PubMed and Medline databases for articles related to IVCFs searchable by October 2022 and a manual search for citations to relevant studies.

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Section: Ivcf For Orthopaedic Management Of Vtementioning

confidence: 99%

The application of inferior vena cava filters in orthopaedics and current research advances

Wang

Zhou

et al. 2022

Front. Bioeng. Biotechnol.

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Interaction of preoperative chemoprophylaxis and tranexamic acid use does not affect transfusion in acetabular fracture surgery

Wadhwa,

Rohde,

Oquendo

et al. 2023

Eur J Orthop Surg Traumatol

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Biomechanical evaluation of seven fixation methods to treat pubic symphysis diastasis using finite element analysis

et al. 2022

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Background Pubic symphysis diastasis (PSD) hinders the connection between bilateral ischia and pubic bones, resulting in instability of the anterior pelvic ring. PSD exceeding 25 mm is considered disruptions of the symphyseal and unilateral/bilateral anterior sacroiliac ligaments and require surgical intervention. The correct choice of fixation devices is of great significance to treat PSD. This study aimed to evaluate the construct stability and implant performance of seven fixation methods to treat PSD using finite element analysis. Methods The intact skeleton-ligament pelvic models were set as the control group. PSD models were simulated by removing relevant ligaments. To enhance the stability of the posterior pelvic ring, a cannulated screw was applied in the PSD models. Next, seven anterior fixation devices were installed on the PSD models according to standard surgical procedures, including single plates (single-Plate group), single plates with trans-symphyseal cross-screws (single-crsPlate group), dual plates (dual-Plate group), single cannulated screws, dual crossed cannulated screws (dual-canScrew group), subcutaneous plates (sub-Plate group), and subcutaneous pedicle screw-rod devices (sub-PedRod group). Compression and torsion were applied to all models. The construct stiffness, symphyseal relative micromotions, and von Mises stress performance were recorded and analyzed. Results The construct stiffness decreased dramatically under PSD conditions. The dual-canScrew (154.3 ± 9.3 N/mm), sub-Plate (147.1 ± 10.2 N/mm), and sub-PedRod (133.8 ± 8.0 N/mm) groups showed better ability to restore intact stability than the other groups (p < 0.05). Regarding regional stability, only single-plate fixation provided unexpected regional stability with a diastasis of 2.1 ± 0.2 mm (p < 0.001) under a compressive load. Under a rotational load, the single-crsPlate group provided better regional angular stability (0.31° ± 0.03°, p < 0.001). Stress concentrations occurred in the single-Plate, sub-Plate, and sub-PedRod groups. The maximum von Mises stress was observed in the single-plate group (1112.1 ± 112.7 MPa, p < 0.001). Conclusion The dual-canScrew fixation device offers ideal outcomes to maintain stability and prevent failure biomechanically. The single-crsPlate and dual-Plate methods effectively improved single-Plate device to enhance regional stability and disperse stresses. The subcutaneous fixation devices provided both anterior pelvic ring stability and pubic symphysis strength.

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Perioperative management of acetabular and pelvic fractures: evidence-based recommendations

Cited by 6 publications

References 132 publications

The application of inferior vena cava filters in orthopaedics and current research advances

The application of inferior vena cava filters in orthopaedics and current research advances

Interaction of preoperative chemoprophylaxis and tranexamic acid use does not affect transfusion in acetabular fracture surgery

Biomechanical evaluation of seven fixation methods to treat pubic symphysis diastasis using finite element analysis

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