Application In Surgical Treatment Of Multiple Fractures Of The Pubic Ramus With Acetabular Anterior Column Fractures

Objective: Objective to explore the application of Kirschner wire in the treatment of multiple fractures of the ramus of pubis and the anterior column of acetabulum,and the methods and techniques of reduction..Materials and Methods: 11 patients cases with multiple fractures of the pubic ramus with acetabular anterior column fractures that had been admitted to orthopedics in our hospital from April 2012 to December 2016 were retrospectively reviewed.Acorrding to Patient data: they were 8 male patients and 3females patients cases;Age from 17 to 65 years old,average age 41.5 years.Among them,8cases of traffic accident trauma,Fall 2 cases,Bruise in 1 cases.According to Tile classfication:there are 7 B2 typing fractures and 3 B3 typing fractures and 1 C1 typing fracture.Combined injury with craniocerebral trauma in 1 cases,1 cases of urethral injury,2 cases of femoral fracture,1 cases of tibial fractures,liver rupture in 2 cases,1 cases of rib fractures and pneumothorax.According to Tile classfication:Anterior column fracture in 5 cases,anterior column with transverse motion of the 3,transverse motion in 3 cases.The operation time was 3~15 d after injury.Results:The incision length,operative time,intraoperative blood loss and postoperative complications were observed.Using Matta imaging to evaluate fracture reduction:Excellent in 8 cases,good in 3 cases,fail in 1 cases.The operation time ranged from 75 to 135 min,with an average of 95 min,and the intraoperative blood loss ranged from 400 to 900 ml,with an average of 600 ml.All patients were followed up for the average time was 12.5 months(average,7 to 18 months).All patients achieved bony healing.The healing time ranged from 2.7 to 5 months(average,3.1 months).1 patient suffer heterotopic ossification after operation,no purulent wound infection,no screw screw loosening,plate fracture prolapse,no abdominal hernia and neurovascular or iatrogenic nerve injury.According to Ma-jeed function scoring system,The total score was 85.32 +,of which there were excellent in 7 cases,good in 2cases,and general in 1 cases.Conclusions:The application of Kirschner wire in the treatment of multiple fractures of the pubic ramus combined with acetabular anterior column fractures.It is good for the reduction of fracture and improve the quality of reduction,promote fracture healing,reduce postoperative complications and long-term quality of life.