Toda Kazukiyo, Yagata Yukihisa, Kikuchi Takeshi, Takigawa Tomoyuki, Ito Yasuo
Department of Orthopaedic Surgery, Kobe Red Cross Hospital, Kobe City, Hyogo 651-0073,
Department of Orthopaedic Surgery, Hyogo Emergency Medical Center, Kobe City, Hyogo 651-0073, Japan.
Acta Med Okayama. 2020 Feb;74(1):27-32. doi: 10.18926/AMO/57949.
Pelvic fractures occur with high-energy trauma, and the patient's clinical status is unstable. Although a number of surgical methods for unstable pelvic fractures are available, none can achieve strong fixation with minimal invasiveness. We describe a surgical transiliac rod and screw fixation (TIF) procedure that provides minimally invasive fixation using a spinal implant for unstable pelvic ring fractures, and we retrospectively analyzed the procedure's outcomes in 27 patients with type B or C1 fractures (based on the AO/ATO classification system). Small skin incisions are made above the posterior superior iliac spines on both sides. The ilium is partially resected, and two iliac screws are inserted on each side. The spinous process of the sacral spine is then shaved, and the iliac screws are connected to 2 rods, one placed caudal to the other. Corrective manipulation is performed at the fracture site, and the rods are connected with connectors. Favorable fracture reduction, defined as a rating of 'excellent' or 'good,' was achieved in 77.8% of the patients. Transiliac rod and screw fixation (TIF) will be a useful therapeutic option for unstable pelvic ring fractures.
骨盆骨折多由高能量创伤所致，患者临床状况不稳定。尽管有多种针对不稳定骨盆骨折的手术方法，但尚无一种能以最小的创伤实现牢固固定。我们描述了一种经髂骨棒螺钉固定术（TIF），该手术使用脊柱植入物对不稳定骨盆环骨折进行微创固定，并且我们回顾性分析了27例B型或C1型骨折（基于AO/ATO分类系统）患者接受该手术的结果。在双侧髂后上棘上方做小皮肤切口。部分切除髂骨，每侧插入两枚髂骨螺钉。然后刮除骶椎棘突，将髂骨螺钉与两根棒连接，一根置于另一根的尾侧。在骨折部位进行矫正手法操作，并用连接器连接棒。77.8%的患者实现了良好的骨折复位，定义为“优”或“良”。经髂骨棒螺钉固定术（TIF）将是不稳定骨盆环骨折的一种有效治疗选择。
