Three-dimensional navigation assisted percutaneous sacroiliac screw combined with external fixator for Tile B and C pelvic fractures / 中华创伤杂志

ABSTRACT

Objective To evaluate the clinical outcomes of three-dimensional navigation assisted percutaneous sacroiliac screw combined with external fixator for the treatment of the Tile B and C pelvic fractures. Methods A retrospective case-control study was conducted on 43 patients with Tile B and C pelvic fractures from January 2014 to June 2017. There were 25 males and 18 females, with an average age of 44.6 years (range, 21-68 years). According to the AO typing, there were seven cases of type B1, 13 type B2, six type B3, 15 type C1, and two type C2. The duration from injury to operation ranged from 4 to 14 days (mean, 8.0 days). Based on the operation method, patients were divided into Group A (n=20) treated by three dimensional navigation assisted percutaneous sacroiliac screw combined with external fixator, and Group B (n = 23) treated by anterior open reduction and plate internal fixation. The two groups were compared in terms of operation time, blood loss, reduction quality by Matta score, Majeed pelvic fractures function score at the last follow up, and postoperative complications. Results All patients were followed up for 6-24 months (mean, 12.7 months). The operation time [(27.5 ± 1.6) minutes] and intraoperative bleeding [(26.3 ± 3.9) ml] in Group A were significantly less than those in Group B [(166.2±3.6)minutes and (128.0 ± 8.9) ml] (＜0.05). There were no significant differences between Group A and Group B in the good and excellent rate of reduction [85％ (17/20) vs.91％ (21/23)], and Majeed score [90％ (18/20) vs.91％ (21/23)](P＞0.05). The incidence of postoperative complication in Group A (10％) was significantly lower than that in Group B (39％) (P ＜0.05). Conclusion Compared with open reduction and plate internal fixation, three dimensional navigation assisted percutaneous sacroiliac screw combined with external fixator is preferable to unstable pelvic fractures due to the shorter operation time, less intraoperative bleeding, and fewer postoperative complications.