Stuby F M, Gonser C E, Baron H C, Stöckle U, Badke A, Ochs B G
Klinik für Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik Tübingen, Eberhard Karls-Universität Tübingen, Schnarrenbergstraße 95, 72076, Tübingen, Deutschland.
Unfallchirurg. 2012 Apr;115(4):330-8. doi: 10.1007/s00113-012-2157-4.
Pelvic ring fractures are considered as rare injuries. Minimally invasive sacroiliac screw fixation has been used increasingly in recent years as an operative strategy for the treatment of these injuries, if the dorsal pelvic ring needed to be addressed. Treatment options for the anterior pelvic ring comprise plates, screws or external fixation.
Based on the limited number of publications on this subject and our own experience with 80 patients who suffered pelvic ring B- or C-type injuries during a period of 8 years we are able to show that the indication for hardware removal in the pelvic ring should be strictly defined.
In some cases like external fixation, implant-associated infection, malpositioning, allergic implant reaction, critical soft tissue covering, palpable hardware and consolidated juvenile fractures implant removal is certainly indicated. In patients without symptoms and in patients with trauma-associated symptoms which are not definitely associated with the hardware, the removal should be only indicated after thorough consideration of the risks versus the benefits and additionally by taking the initial injury pattern into account. If despite all these objections the hardware removal has been indicated it should always be considered that hardware removal may be challenging with several possible severe complications.
骨盆环骨折被认为是罕见损伤。近年来，对于需要处理骨盆后环的此类损伤，微创骶髂螺钉固定作为一种手术策略已越来越多地被采用。骨盆前环的治疗选择包括钢板、螺钉或外固定。
基于关于该主题的有限数量的出版物以及我们在8年期间对80例骨盆环B型或C型损伤患者的经验，我们能够表明骨盆环内固定物取出的适应证应严格界定。
在某些情况下，如外固定、植入物相关感染、位置不当、植入物过敏反应、关键软组织覆盖、可触及的内固定物以及青少年骨折愈合后的内固定物，取出内固定物肯定是必要的。对于无症状患者以及有与创伤相关但不确定与内固定物相关的症状的患者，在充分权衡风险与益处并考虑初始损伤类型后，才应考虑取出内固定物。如果尽管有这些顾虑仍决定取出内固定物，应始终考虑到取出内固定物可能具有挑战性且可能会出现几种严重并发症。
