Maharat Nakhon Ratchasima Hospital, 49 Changphuak Road, Nai Mueang Subdistrict, Mueang Nakhon Ratchasima District, Nakhon Ratchasima, 30000, Thailand.
Eur J Orthop Surg Traumatol. 2023 Dec;33(8):3443-3448. doi: 10.1007/s00590-023-03555-5. Epub 2023 May 15.
To compare outcomes of fluoroscopic-assisted supra-acetabular pin placement percutaneous technique versus the open technique in traumatic pelvic fractures.
Prospective randomized controlled trial was performed at Maharat Nakhon ratchasima hospital from January 2020 to March 2021. Time, size of wound, and position of supra-acetabular pin were recorded intraoperatively. Pin positions were confirmed and measured by postoperative CT scan. Complications such as cortex penetration, infection, hip joint violation, and lateral thigh numbness were recorded at 2 weeks postoperatively.
Twenty patients (40 hemipelvis) were randomized to fluoroscopic-assisted and non-fluoroscopic groups. Time taken for supra-acetabular pin placement for fluoroscopic-assisted and non-fluoroscopic-assisted groups was 211 and 522 s, respectively (P value < 0.001). Average wound size was 2.81 cm in the fluoroscopic-assisted group and 6.01 cm in the non-fluoroscopic-assisted group (P value < 0.001). Overall complications were similar in both groups with higher infection rates in the fluoroscopic-assisted group (5 and 0%, respectively).
Pelvic fracture is a life-threatening condition, which requires emergency pelvic stabilization. This study examined operative times for supra-acetabular placement and complication rates. The results show shorter operative times for the non-fluoroscopic-assisted technique without significant differences in complication rates.
Non-fluoroscopic technique greatly reduced operative times for supra-acetabular pin placement with comparable safety to the fluoroscopic-assisted technique.
比较透视辅助髋臼上方钉放置经皮技术与开放性技术在创伤性骨盆骨折中的疗效。
前瞻性随机对照试验于 2020 年 1 月至 2021 年 3 月在玛哈叻那空猜是医院进行。术中记录透视辅助与非透视辅助组手术时间、伤口大小和髋臼上方钉位置。术后 CT 扫描确认和测量钉位置。术后 2 周记录并发症,如皮质穿透、感染、髋关节侵犯和大腿外侧麻木。
20 例(40 个半骨盆)患者随机分为透视辅助组和非透视辅助组。透视辅助组和非透视辅助组髋臼上方钉放置时间分别为 211s 和 522s(P 值<0.001)。透视辅助组平均伤口大小为 2.81cm,非透视辅助组为 6.01cm(P 值<0.001)。两组总体并发症相似,透视辅助组感染率较高(分别为 5%和 0%)。
骨盆骨折是一种危及生命的疾病,需要紧急骨盆稳定。本研究检查了髋臼上方钉放置的手术时间和并发症发生率。结果显示,非透视辅助技术的手术时间更短,并发症发生率无显著差异。
非透视辅助技术大大缩短了髋臼上方钉放置的手术时间,与透视辅助技术具有相当的安全性。