[Treatment of unstable pelvic fractures with minimally invasive internal fixation].

OBJECTIVE

To explore the clinical effects of minimally invasive internal fixation in the treatment of unstable pelvic fractures.

METHODS

From January 2005 to January 2009, the data of 48 patients with unstable pelvic fractures were retrospectively analyzed. There were 31 males and 17 females. The age ranged from 12 to 66 years with an average of 37.8 years. Among them, 29 cases were caused by traffic accident, 14 by fall from height and 5 by crush injury. According to Tile's classification, type B1 was in 4 cases, B2 in 3, C1 in 25, C2 in 14 and C3 in 2. All patients were treated with minimally invasive internal fixation of percutaneous reconstruction plate (including 20 cases with percutaneous pubic ramus screws fixation and 8 cases with pubic tubercle screws fixation) and percutaneous sacroiliac screws (including 16 cases with percutaneous pubic ramus screws fixation and 4 cases with pubic tubercle screws fixation). With X-ray films to observe the reduction of fractures and according to Majeed standard to evaluate the clinical effects.

RESULTS

All patients were followed up for 12-39 months with an average of 17 months. No infection of incision,nerve injuries, loosening or breakage of the screw was found. All cases attained bone union. Anatomical reduction achieved in 29 cases,satisfactory reduction 18 cases, and unsatisfactory reduction 1 case. According to the Majeed standards, 29 cases obtained excellent results, 15 good and 4 fair, the rate of excellent and good was 91.7%.

CONCLUSION

Treatment of unstable pelvic fractures with minimally invasive internal fixation had advantages of minimal trauma, less bleeding, less postoperative complications, high bone union rate, reliable fixation and satisfactorily functional recovery after operation, but the method demanded skillful surgical techniques.