Sharma Sushank, Aggarwal Sameer, Patel Sandeep, Kumar Vishal, Jindal Karan, Sinha Anindita
Department of Orthopaedics Surgery, Pgimer, Chandigarh, India.
Department of Radiodiagnosis, Pgimer, Chandigarh, India.
J Orthop. 2021 Jan 16;23:142-149. doi: 10.1016/j.jor.2021.01.004. eCollection 2021 Jan-Feb.
Complex fracture patterns of anterior pelvic ring are a challenge and usually needs extensive surgeries. The purpose of this study was to evaluate INFIX as a minimally invasive procedure for such injuries in terms of feasibility, outcomes and complications in the Indian population.
Patients with complex fracture patterns of anterior pelvic ring were selected for anterior INFIX application along with standard posterior stabilization. Outcomes were assessed radiographically by Matta's criteria and amount of displacement. Post-operative CT scan for relation of implant to vital structures and Doppler at varying hip flexion for possible vascular occlusion was used. Functional outcomes included both disease specific scores (Majeed score, IOWA pelvic score) and quality of life scores (SMFA, SF-12). Complications were also noted.
12 cases out of 112 patients had complex fracture pattern of the anterior ring. Most common injury pattern were LC-3 and VS (n = 6 and 3) Young and Burgess type. The average follow up was 6 months. Fracture reduction as per Matta's criteria was excellent in 10 (83.3%) cases and good in 2 (16.6%) cases with functional outcomes excellent in 11 cases, and a mean Majeed score of 92.67 ± 5.8. The average SMFA score was 51 ± 4.39 and mean SF-12 scores for physical and mental health were 48.493 ± 6.74 and 56.370 ± 4.04 respectively. Complications noted were lateral femoral cutaneous nerve palsy (1/24 nerves), skin dehiscence (n = 2), infection (n = 2) and sacral nonunion (n = 1).
INFIX is a safe and effective minimally invasive technique for addressing complexfracture patterns involving the anterior half of pelvic ring with excellent fracture reduction, radiological and functional outcomes and predictable fracture healing.
骨盆前环复杂骨折模式是一项挑战，通常需要进行广泛的手术。本研究的目的是评估INFIX作为一种针对此类损伤的微创手术在印度人群中的可行性、疗效和并发症情况。
选择骨盆前环复杂骨折模式的患者进行前路INFIX应用并联合标准后路固定。通过Matta标准和移位量进行影像学评估疗效。使用术后CT扫描评估植入物与重要结构的关系，并在不同髋关节屈曲角度使用多普勒检查是否可能出现血管闭塞。功能结局包括疾病特异性评分（Majeed评分、爱荷华骨盆评分）和生活质量评分（SMFA、SF-12）。同时记录并发症情况。
112例患者中有12例存在前环复杂骨折模式。最常见的损伤模式为LC-3和VS（n = 6和3），属于Young和Burgess分型。平均随访时间为6个月。根据Matta标准，骨折复位情况为10例（83.3%）优秀，2例（16.6%）良好，11例功能结局优秀，平均Majeed评分为92.67 ± 5.8。平均SMFA评分为51 ± 4.39，身心健康的平均SF-12评分分别为48.493 ± 6.74和56.370 ± 4.04。记录到的并发症有股外侧皮神经麻痹（24条神经中的1条）、皮肤裂开（n = 2）、感染（n = 2）和骶骨不愈合（n = 1）。
INFIX是一种安全有效的微创手术技术，用于处理涉及骨盆环前半部分的复杂骨折模式，具有出色的骨折复位、影像学和功能结局以及可预测的骨折愈合情况。
