M-shaped Plate Fixation For Posterior Pelvic Ring Injury:a Stability Study

Objective:To report the clinical experience that M-shaped plate fixation for injuries at the posterior ring of pelvis.Methods:The clinical data of42cases with injuries at the posterior ring of pelvis undergoing M-shaped plate were analyzed retrospectively. There were28males and14females, at age range of18-56years (mean37years). Injury causes included traffic accidents in23patients, crush in11patients and fall from height in8patients. According to Tile classification, there are4type B1,6type B2,4type B3,17type C1,8type C2and3type C3. The anterior pelvic ring injuries:16patients have separation of symphysis pubis,14patients have unilateral pubis fracture,12patients have bilateral pubis fracture and8patients have acetabular fractures. Associated injuries:17patients have shock,23patients have upper or(and) lower limb fractures,12patients have head injuries,11patients have chest injuries,4patients have urological injuries and14patients have sacral plexus injuries. Radiological assessment depended on plain X-ray views (anteroposterior, inlet, outlet and lateral views) and on computed tomography(CT) scans. Fracture reduction was evaluated by Matta criterion and function was evaluated by Majeed functional scoring. The one-way analysis of variance(ANOVA) test was used to examine possible correlation between the Matta criterion and the Majeed functional scoring.Results: The average intraoperative time was1.5hours (ranging from1to2hours), and the average intraoperative blood was190ml (ranging from80to300ml).There was no iatrogenic nerve injury and all the incisions healed during the primary procedure. All the patients were available at follow-up, with a mean period of21.5months (ranging from7to36months). According to Matta criterion for fracture reduction, the results were excellent in27patients, good in10and fair in5, with excellence rate of88.1%. According to the Majeed functional scoring, the results were excellent in25patients, good in11and fair in6, with excellence rate of85.7%. Nine of14patients with sacral plexus injuries had compele neurological recovery and5patients had partial recovery. The difference between the Matta criterion and the Majeed functional scoring was statistically insignificant.Conclusions:M-shaped plate fixation for injuries at the posterior ring of pelvis has the advantages of broad indications, simplicity of operator, short intraoperative time, small trauma, less bleeding, less complication, and significant clinical efficacy, which is worth spreading.