Plate Osteosynthesis, Subcutaneous Internal Fixation and Anterior Pelvic Bridge Fixation

Cole, Peter A.; Dyskin, Evgeny; Gilbertson, Jeffrey A.; Mayr, Edgar

doi:10.1007/978-3-319-66572-6_20

Cited by 3 publications

(5 citation statements)

References 50 publications

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“…Besides the risks, connected to any open procedure, there is a high risk of implant loosening or breakage [37]. Minimal-invasive stabilization techniques have been developed for the anterior pelvis, although results of large series in the elderly population are not available to date [38][39][40][41]. Further biomechanical work and feasibility studies are needed to find the most reliable solution.…”

Section: Discussionmentioning

confidence: 99%

Operative treatment of fragility fractures of the pelvis: a critical analysis of 140 patients

Rommens

Hofmann

Kraemer

et al. 2021

Eur J Trauma Emerg Surg

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Background Fragility fractures of the pelvis (FFP) are a clinical entity with an increasing frequency. Indications for and type of surgical treatment are still a matter of debate. Purpose This retrospective study presents and critically analyses the results of operative treatment of 140 patients with FFP. Setting Level-I trauma center. Materials and methods Demographic data, comorbidities, FFP-classification, type of surgical stabilization (percutaneous (P-group) versus open procedure (O-group)), length of hospital stay (LoS), general in-hospital complications, surgery-related complications, living environment before admission, mobility and destination at discharge were retracted from the medical and radiographic records. Patients were asked participating in a survey by telephone call about their quality of life. SF-8 Physical Component Score (PCS) and SF-8 Mental Component Score (MCS) were calculated as well as the Parker Mobility Score (PMS) and the Numeric Rating Scale (NRS). Results Mean age was 77.4 years and 89.3% of patients were female. 92.1% presented with one comorbidity, 49.3% with two or more comorbidities. Median length of hospital stay was 18 days, postoperative length of hospital stay was 12 days. 99 patients (70.7%) received a percutaneous operative procedure, 41 (29.3%) an open. Patients of the O-group had a significantly longer LoS than patients of the P-group (p = 0.009). There was no in-hospital mortality. There were significantly more surgery-related complications in the O-group (43.9%) than in the P-group (19.2%) (p = 0.006). Patients of the O-group needed more often surgical revisions (29.3%) than patients of the P-group (13.1%) (p = 0.02). Whereas 85.4% of all patients lived at home before admission, only 28.6% returned home at discharge (p < 0.001). The loss of mobility at discharge was not influenced by the FFP-classes (p = 0.47) or type of treatment (p = 0.13). One-year mortality was 9.7%. Mortality was not influenced by the FFP-classes (p = 0.428) or type of treatment (p = 0.831). Median follow-up was 40 months. SF-8 PCS and SF-8 MCS were moderate (32.43 resp. 54.42). PMS was 5 and NRS 4. Follow-up scores were not influenced by FFP-classes or type of treatment. Conclusion Patients with FFP, who were treated operatively, suffered from a high rate of non-lethal general, in-hospital complications. Open surgical procedures induced more surgery-related complications and surgical revisions. Mental and physical follow-up scores are low to moderate. Condition at follow-up is not influenced by FFP-classes or type of treatment. Indications for operative treatment of FFP must be critically examined. Surgical fixation should obtain adequate stability, yet be as less invasive as possible. The advantages and limitations of different surgical techniques have to be critically evaluated in prospective studies.

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Section: Discussionmentioning

confidence: 99%

Operative treatment of fragility fractures of the pelvis: a critical analysis of 140 patients

Rommens

Hofmann

Kraemer

et al. 2021

Eur J Trauma Emerg Surg

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“…Indications for internal fixation include unstable unilateral or bilateral pubic rami fractures isolated or combined with posterior pelvic fractures. Bilateral screws are inserted from the AIISs to the PSISs using a curved rod, connected to both screw heads, inserted subcutaneously over the anterior pelvis 66) . Complications including femoral nerve palsy and damage to the lateral femoral cutaneous nerve have been reported 67 68 69) .…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Plate osteosynthesis, which provides the strongest mechanical fixation for pelvic bone, is best indicated for pure ligamentous disruptions of the pubic symphysis or parasymphyseal fractures 66) . The technique is performed using a transverse suprapubic Pfannenstiel incision or vertical midline incision.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…The technique is performed using a transverse suprapubic Pfannenstiel incision or vertical midline incision. The modified Stoppa approach can be used for the majority of anterior pelvic ring fractures 66) . Small fragment curved plates are used with the longest-possible screw trajectories in order to obtain good purchase 17 66) .…”

Section: Treatment Optionsmentioning

confidence: 99%

“…The modified Stoppa approach can be used for the majority of anterior pelvic ring fractures 66) . Small fragment curved plates are used with the longest-possible screw trajectories in order to obtain good purchase 17 66) . Double plate osteosynthesis is recommended for chronic instabilities or bone defects and is associated with a lower rate and later onset of screw loosening compared to single plate osteosynthesis 26 73) .…”

Section: Treatment Optionsmentioning

confidence: 99%

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Fragility Fractures of the Pelvis and Sacrum: Current Trends in Literature

et al. 2022

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Fragility fractures of the pelvis (FFP) and fragility fractures of the sacrum (FFS), which are emerging in the geriatric population, exhibit characteristics that differ from those of pelvic ring disruptions occurring in the younger population. Treatment of FFP/FFS by a multidisciplinary team can be helpful in reducing morbidity and mortality with the goal of reducing pain, regaining early mobility, and restoring independence for activities of daily living. Conservative treatment, including bed rest, pain therapy, and mobilization as tolerated, is indicated for treatment of FFP type I and type II as loss of stability is limited with these fractures. Operative treatment is indicated for FFP type II when conservative treatment has failed and for FFP type III and type IV, which are displaced fractures associated with intense pain and increased instability. Minimally invasive stabilization techniques, such as percutaneous fixation, are favored over open reduction internal fixation. There is little evidence regarding outcomes of patients with FFP/FFS and more literature is needed for determination of optimal management. The aim of this article is to provide a concise review of the current literature and a discussion of the latest recommendations for orthopedic treatment and management of FFP/FFS.

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Fragility Fractures of the Pelvis and Sacrum

Lee

Kim

2023

J Korean Fract Soc

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Plate Osteosynthesis, Subcutaneous Internal Fixation and Anterior Pelvic Bridge Fixation

Cited by 3 publications

References 50 publications

Operative treatment of fragility fractures of the pelvis: a critical analysis of 140 patients

Operative treatment of fragility fractures of the pelvis: a critical analysis of 140 patients

Fragility Fractures of the Pelvis and Sacrum: Current Trends in Literature

Fragility Fractures of the Pelvis and Sacrum

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