Department of Orthopaedic Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Department of Orthopaedic Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Injury. 2024 Jul;55(7):111600. doi: 10.1016/j.injury.2024.111600. Epub 2024 May 6.
The management of unstable pelvic ring fractures, typically resulting from high-energy trauma, presents a significant clinical challenge due to the complexity of injuries. While effective in many cases, the traditional stabilization methods are fraught with various complications that can significantly impact patient recovery and quality of life (QOL). This study aims to evaluate the efficacy and precision of the anterior subcutaneous internal fixator (INFIX) technique when used with intraoperative computed tomography (CT) navigation, a novel approach intended to mitigate the limitations of conventional treatment modalities. Our retrospective case series encompasses 43 patients who sustained traumatic pelvic injuries and were subsequently treated with the INFIX technique from December 2020 to January 2024. The focus of this analysis was to assess the accuracy of INFIX screw placement facilitated by intraoperative CT navigation. A total of 81 INFIX screws were inserted, and our study findings reveal a high level of precision in screw placement, with only one screw deviating, resulting in an inaccuracy rate of merely 1.2 %. This highlights the significant advantage provided by intraoperative CT navigation. The high level of accuracy not only enhances the stability of the pelvic fixation but also substantially reduces the risk of complications commonly associated with screw misplacement, such as abdominal damage, vascular injury, and issues related to incorrect hardware positioning. In conclusion, the integration of the INFIX technique with intraoperative CT navigation in the treatment of unstable pelvic ring fractures represents a significant advancement in orthopedic trauma surgery. This study provides compelling evidence supporting the efficacy and precision of this approach, suggesting its potential as a superior alternative to traditional fixation methods. Further research, ideally through prospective studies involving larger patient cohorts, is needed to validate these findings and explore the long-term implications of this technique on patient recovery and QOL.
不稳定骨盆环骨折的管理，通常是由高能创伤引起的，由于损伤的复杂性，这是一个重大的临床挑战。虽然在许多情况下有效，但传统的稳定方法存在各种并发症，这会严重影响患者的恢复和生活质量（QOL）。本研究旨在评估前皮下内固定器（INFIX）技术与术中计算机断层扫描（CT）导航联合应用的疗效和精度，这是一种旨在减轻传统治疗方法局限性的新方法。我们的回顾性病例系列包括 43 名因创伤性骨盆损伤而接受 INFIX 技术治疗的患者，该系列的时间范围为 2020 年 12 月至 2024 年 1 月。本分析的重点是评估术中 CT 导航辅助下 INFIX 螺钉放置的准确性。总共插入了 81 枚 INFIX 螺钉，我们的研究结果显示螺钉放置具有很高的精度，只有一枚螺钉偏离，准确率仅为 1.2%。这突出了术中 CT 导航的显著优势。高精度不仅增强了骨盆固定的稳定性，而且大大降低了与螺钉错位相关的并发症风险，如腹部损伤、血管损伤以及与不正确的硬件定位相关的问题。总之，将 INFIX 技术与术中 CT 导航相结合治疗不稳定骨盆环骨折是骨科创伤手术的重大进展。本研究提供了有力的证据支持这种方法的疗效和精度，表明其可能是传统固定方法的更好替代方法。需要进一步的研究，理想情况下是通过涉及更大患者队列的前瞻性研究，来验证这些发现，并探讨该技术对患者恢复和生活质量的长期影响。
