Anterior Subcutaneous Internal Fixation Combined With Posterior Tension Band Plate For Unstable Pelvic Anterior And Posterior Pelvic Ring Fractures

Objective:To investigate the clinical effect of anterior subcutaneous internal fixation(INFIX)combined with posterior tension band plate in the treatment of anterior and posterior pelvic ring fractures.Methods:A total of 32 pelvic fractures involving unstable anterior and posterior pelvic ring injuries were collected from our group at the Department of osteogenesis,the second hospital of Shanxi Medical University,Shanxi,China from May 2020 to January 2021.Of these,15 cases met the criteria of closed reduction by traction,including 9 males and 6 females;The age ranged from 16 to 65 years with a mean of 40.8.Disease duration,3-14 days.Ten cases of road traffic injury,one case of crush injury,four cases of fall injury from height,six cases of combined limb fracture,two cases of spinal fracture,three cases of multiple rib fractures and lung contusion were classified as unstable pelvic fracture,all of which belonged to tilec type.Preoperative pelvis radiographs(anteroposterior,inlet,outlet)and 3D reconstruction of the pelvis CT were routinely performed.An inbuilt external fixator(infix)was used to fix the anterior pelvic ring,while a tension band plate was used to fix the posterior ring,and the evaluation indexes included operative time,intraoperative blood loss,stapling situation,reduction situation(Matta criteria to evaluate the quality of fracture reduction),and postoperative function situation(Majeed function score).Results:The surgical incision was 10 to 14 c m long,the operation time was 80 to100 m i n,with a mean of 90.2min,and the intraoperative bleeding was 60 to 100 m L,with an average of 78 m L.All 15 patients were followed up for 9 to 14 months,with an average of 12.2 months;all fractures were healed between 10 to20 weeks,starting weight bearing from 3 to 12 weeks.According to Matta score criteria,excellent 8 cases,7 good rate 100%,Majeed function score of 83.5 to96,90.3,14 excellent,1 good rate 100%.;However,three cases had different degrees of lateral femoral cutaneous nerve symptoms,one case was spontaneously relieved on the next day,and the remaining two cases were gradually relieved by oral nutritional nerve drug(methocobalamin);one case had wound infection,and healed with debridement and indwelling VSD negative pressure drainage.Conclusion:INFIX combined with posterior tension band plate is an effective treatment for partial anterior and posterior pelvic ring fractures.And the operation is easy and safe,with little surgical bleeding,and the operation meets the principles of orthopedic minimally invasive medical treatment and precision medicine,which is beneficial to the recovery of postoperative function of patients and achieves rapid recovery(ERAS).