Treatment of posterior pelvic ring injuries with minimally invasive percutaneous plate osteosynthesis

Tang, Hao; Yang, Chen; Zhang, Qiulin

doi:10.1007/s00264-009-0756-7

Cited by 37 publications

(39 citation statements)

References 27 publications

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“…In a preliminary clinical study the TIFI has proven to be a system with a low complication rate, as far as iatrogenic vessel or nerve damage [16,23]. In this experimental setting we found that the biomechanical characteristics of the TIFI are comparable to those of established methods.…”

Section: Discussionsupporting

confidence: 61%

Biomechanical analysis of a transiliac internal fixator

Dienstknecht

Berner

Lenich

et al. 2011

International Orthopaedics (SICOT)

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Purpose We evaluated the biomechanical characteristics of the transiliac internal fixator (TIFI) as compared to two wellestablished methods of internal posterior pelvic ring fixation. Methods Six freshly frozen human pelves were used for simulated single-leg stance loading of an AO type C injury model (pubic symphysis diastasis and unilateral sacroiliac joint disruption). The symphysis rupture was stabilized with a dynamic compression plate. Afterwards the three internal stabilization systems (TIFI, iliosacral screws and ventral plate osteosynthesis) were analysed. Fragment movement was measured in a contact-free manner with a stereophotometric infrared system. Results No significant differences in the three-dimensional deformation tolerated by the TIFI as compared to the other internal fixation systems were found. Conclusions The transiliac internal fixator provides the same biomechanical stability as the other reference implants tested. We suggest the use of this device as a suitable alternative to the other implants.

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Section: Discussionsupporting

confidence: 61%

Biomechanical analysis of a transiliac internal fixator

Dienstknecht

Berner

Lenich

et al. 2011

International Orthopaedics (SICOT)

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“…Anatomic reduction and screw position then were checked intraoperatively using AP (Fig. 4) and inlet/outlet view radiographs (15). We performed closed reduction manually, except in two patients in whom a Schanz screw [29] was used as a joystick.…”

Section: Methodsmentioning

confidence: 99%

“…When using posterior open reduction and internal fixation, the range of wound complications varies among studies from 5% to 25% [15,18,32]. Minimally invasive, percutaneous procedures minimize soft tissue injury but the risk of iatrogenic neurovascular lesions is not negligible.…”

Section: Introductionmentioning

confidence: 99%

A Minimally Invasive Stabilizing System for Dorsal Pelvic Ring Injuries

Dienstknecht

Berner

Lenich

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Open reduction and stabilization of dorsal pelvic ring injuries is accompanied by a high rate of soft tissue complications. Minimally invasive techniques have the potential to decrease soft tissue trauma, but the risk of iatrogenic nerve and vessel damage through the reduced surgical exposure should be considered. We treated these injuries using a transiliac internal fixator (TIFI) in a minimally invasive technique characterized by implantation of a pedicle screw and rod system, bridging the sacroiliac joints and the sacral area. Questions/purposes We asked whether (1) we could achieve anatomic restoration with the device, (2) specific complications were associated with this minimally invasive approach (particularly enhanced intraoperative blood loss, soft tissue complications, and iatrogenic neurovascular damage), and (3) function 3 years after trauma was comparable to that of established methods. Methods We retrospectively reviewed 67 patients with dorsal pelvic injuries during a 7-year period. We evaluated the (1) reduction by grading the maximal displacement measured with three radiographic views, (2) the complications during the observation period, and (3) the function with a validated questionnaire (Pelvic Outcome Score) in all but five patients at least 3 years after trauma (mean, 37 months; range, 36-42 months). Results At last followup we observed a secondary fracture displacement greater than 5 mm in one patient. The intraoperative blood loss was less than 50 mL in all patients. No neurovascular lesions occurred owing to implantation. Four patients had wound infections, one had loosening of a single pedicle screw, and one had an iatrogenic screw malpositioning. Thirty-five of the 62 patients achieved Pelvic Outcome Scores of either a maximum score or 6 of 7 points. Conclusion Our observations suggest TIFI is a reasonable alternative to other established fixation devices for injuries of the dorsal pelvic ring with minor risks of major blood loss or iatrogenic neurovascular damage.

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“…Although this method could also reduce secondary damage to the blood vessels and nerves, it causes the patient discomfort because the steel plate is placed directly under the skin and is palpable (although in the report, they did not receive such complaints from patients); therefore, the authors also believed that the steel plate should be removed after a relatively short period. Moreover, in this fixation method, the steel plate is not tightly attached to the fracture, and the force arm is large; therefore, the fixation is unstable, and there is the possibility of micro-movement in the fracture, which affects fracture healing [17][18][19][20][21]. We treated the 15 patients with pubic ramus MIPO fixation, and with one exception, all of the patients denied discomfort and lived a normal life.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive treatment for pubic ramus fractures combined with a sacroiliac joint complex injury

Tang

Zhou

et al. 2013

International Orthopaedics (SICOT)

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Purpose Fractures of the pubic rami due to low energy trauma are common in the elderly, with an incidence of 26 per 100,000 people per year in those aged more than 60 years. The purpose of this study was to evaluate the clinical application of this minimally invasive technique in patients with pubic ramus fractures combined with a sacroiliac joint complex injury, including its feasibility, merits, and limitations.

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Treatment of posterior pelvic ring injuries with minimally invasive percutaneous plate osteosynthesis

Cited by 37 publications

References 27 publications

Biomechanical analysis of a transiliac internal fixator

Biomechanical analysis of a transiliac internal fixator

A Minimally Invasive Stabilizing System for Dorsal Pelvic Ring Injuries

Minimally invasive treatment for pubic ramus fractures combined with a sacroiliac joint complex injury

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