Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, 760-8557 Takamatsu, Kagawa, Japan.
Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, 760-8557 Takamatsu, Kagawa, Japan.
Orthop Traumatol Surg Res. 2021 Oct;107(6):103008. doi: 10.1016/j.otsr.2021.103008. Epub 2021 Jul 1.
Anterior external fixation (EF), as the primary treatment for unstable pelvic fractures, is performed with patients in the supine position. In most cases, however, definitive surgery for posterior fixation is performed first in the prone position without EF. We report the case of a patient with unilateral and vertically unstable pelvic fracture whom we had treated with minimally invasive spinopelvic fixation, with retention of the anterior EF in a lateral position. Reduction of the residual displacement was performed with percutaneous spinal instrumentation, and acceptable reduction was achieved. At the 13-month follow-up, the functional outcome, calculated using the Majeed Score, was 87 points. The plain radiograph showed good bone union, except for the right superior pubic ramus. The radiological outcome, measured using the Matta rating, was excellent. Thus, retaining the EF facilitates safe and accurate reduction without major surgical complications and may offer surgeons an additional management option for such fractures.
前路外固定（EF）作为不稳定骨盆骨折的主要治疗方法，患者取仰卧位进行。然而，在大多数情况下，首先在俯卧位进行确定性的后路固定，而不使用 EF。我们报告了一例单侧垂直不稳定骨盆骨折患者的病例，我们采用微创脊柱骨盆固定术治疗，保留侧位的前路 EF。通过经皮脊柱器械进行残余移位的复位，达到了可接受的复位。在 13 个月的随访中，采用 Majeed 评分计算的功能结果为 87 分。平片显示除了右侧耻骨上支外，骨愈合良好。采用 Matta 评分测量的影像学结果为优秀。因此，保留 EF 有助于安全、准确地复位，且不会出现重大手术并发症，可能为外科医生提供此类骨折的另一种治疗选择。
