Omran Khaled, Nady Ahmed, Abdelhaliem Ali Ahmed Hisham, Khamies Mohamed Sayed
Department of Orthopedic Surgery and Traumatology, Minia University Hospital, Faculty Of Medicine, Minia University, Minya, Egypt.
Arch Orthop Trauma Surg. 2025 May 9;145(1):282. doi: 10.1007/s00402-025-05891-z.
Pelvic fractures are frequently presented to major trauma centers and are mostly associated with high morbidity, especially in polytrauma patients. While stable fractures are managed non-operatively in most cases, unstable patterns necessitate surgical fixation because of the significant morbidity and mortality related to unstable pelvic fractures.
To compare the clinical, radiological, and functional outcomes in patients with unstable pelvic ring fractures treated with anterior minimal invasive internal fixator (INFIX) versus plate fixation.
Retrospective single-center clinical study.
This research was conducted on 60 patients with unstable pelvic ring injuries. There were 38 (63.3%) males and 22 (36.7%) females with a mean age of 33.57 ± 11.03 years. Half of the patients were managed with INFIX, and the other half with open plating. Pelvic deformity index (PDI) and symphyseal widening were used to assess the pelvic ring reductions.
Reduction of symphyseal widening was significantly better in open plating than in the INFIX group (P < 0.001), but both techniques are comparable in reducing PDI. Time to surgery, whole operative time, anterior pelvic ring procedure time, hospital stay, and blood loss decreased significantly in the INFIX group compared to the plate group (P < 0.001).
INFIX is a minimally invasive procedure that provides much lower operative time and less blood loss than open plating in the anterior pelvic ring fracture management. Meanwhile, more anatomical reduction of the anterior pelvic ring fracture was achieved through plate fixation. There was a significant difference in the postoperative symphyseal diastasis achieved with plating compared to INFIX [plating (5.47 ± 2.03 mm) lower than INFIX(11.40 ± 3.76 mm)].
骨盆骨折常出现在大型创伤中心，大多伴有高发病率，尤其是在多发伤患者中。虽然大多数情况下稳定型骨折采用非手术治疗，但不稳定型骨折因与不稳定骨盆骨折相关的高发病率和死亡率而需要手术固定。
比较采用前路微创内固定器（INFIX）与钢板固定治疗不稳定骨盆环骨折患者的临床、影像学和功能结局。
回顾性单中心临床研究。
本研究纳入60例不稳定骨盆环损伤患者。其中男性38例（63.3%），女性22例（36.7%），平均年龄33.57±11.03岁。一半患者采用INFIX治疗，另一半采用切开钢板内固定。采用骨盆畸形指数（PDI）和耻骨联合增宽来评估骨盆环复位情况。
切开钢板内固定组耻骨联合增宽的复位明显优于INFIX组（P<0.001），但两种技术在降低PDI方面具有可比性。与钢板组相比，INFIX组的手术时间、总手术时间、骨盆前路手术时间、住院时间和失血量均显著减少（P<0.001）。
INFIX是一种微创手术，在前路骨盆环骨折治疗中，其手术时间比切开钢板内固定短得多，失血量也少。同时，通过钢板固定能更解剖复位前路骨盆环骨折。与INFIX相比，钢板固定术后耻骨联合分离有显著差异[钢板固定（5.47±2.03mm）低于INFIX（11.40±3.76mm）]。
