The management of unstable pelvic ring fractures, typically resulting from high-energy trauma, presents a significant clinical challenge due to the complexity of injuries. While effective in many cases, the traditional stabilization methods are fraught with various complications that can significantly impact patient recovery and quality of life (QOL). This study aims to evaluate the efficacy and precision of the anterior subcutaneous internal fixator (INFIX) technique when used with intraoperative computed tomography (CT) navigation, a novel approach intended to mitigate the limitations of conventional treatment modalities. Our retrospective case series encompasses 43 patients who sustained traumatic pelvic injuries and were subsequently treated with the INFIX technique from December 2020 to January 2024. The focus of this analysis was to assess the accuracy of INFIX screw placement facilitated by intraoperative CT navigation. A total of 81 INFIX screws were inserted, and our study findings reveal a high level of precision in screw placement, with only one screw deviating, resulting in an inaccuracy rate of merely 1.2 %. This highlights the significant advantage provided by intraoperative CT navigation. The high level of accuracy not only enhances the stability of the pelvic fixation but also substantially reduces the risk of complications commonly associated with screw misplacement, such as abdominal damage, vascular injury, and issues related to incorrect hardware positioning. In conclusion, the integration of the INFIX technique with intraoperative CT navigation in the treatment of unstable pelvic ring fractures represents a significant advancement in orthopedic trauma surgery. This study provides compelling evidence supporting the efficacy and precision of this approach, suggesting its potential as a superior alternative to traditional fixation methods. Further research, ideally through prospective studies involving larger patient cohorts, is needed to validate these findings and explore the long-term implications of this technique on patient recovery and QOL.
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http://dx.doi.org/10.1016/j.injury.2024.111600 | DOI Listing |
Chin J Traumatol
January 2025
Department of Emergency Surgery and Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, 250012, China. Electronic address:
Purpose: The fixation method commonly employed worldwide for treating unstable fractures of the posterior pelvic ring is the percutaneous iliosacral screw technique. However, prolonged operation time and frequent fluoroscopies result in surgical risks. This study aimed to investigate whether a new triangulation method could reduce operative and fluoroscopy times and increase the accuracy of screw placement.
View Article and Find Full Text PDFInjury
January 2025
Department of Surgery, The Trauma and Orthopaedic Research Unit, The Canberra Hospital, Garran, Australian Capital Territory, Australia.
Background: Unstable posterior pelvic-ring fractures are rare and difficult to manage. There are many injury patterns, they are associated with high morbidity and mortality, and optimal surgical management remains contentions. This study aims to compare outcomes and complications for different surgical management of these injuries.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Klinik für Orthopädie und Unfallchirurgie, UK-SH, Campus Kiel, Germany.
Background: Pelvic ring and acetabular fractures are among the most complicated and severe injury patterns in orthopaedic trauma surgery. Inpatient treatment is not only costly but also very time-consuming. The aim of this study is to identify predictors leading to a prolonged length of hospital stay.
View Article and Find Full Text PDFBioengineering (Basel)
January 2025
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, 48149 Münster, Germany.
(1) Background: The incidence of fragility fractures of the pelvis (FFP) has increased significantly over the past decades. Unilateral non-displaced fractures, defined as FFP II, are the most common type of fracture. When conservative treatment fails, surgical treatment is indicated.
View Article and Find Full Text PDFInjury
January 2025
Professor of Orthopedics - Section Head Trauma & Orthopaedic Surgery, School of Medicine University of Leeds, UK.
The term "fragility fractures of the pelvis" refers to the disruptions of the pelvic ring that are caused by low energy injuries (such as low-level falls or falls from the standing position) in the elderly population (age over 65 years) in the absence of metastatic bone disease. These fractures are increasing in numbers, due to the aging population, particularly in the developed countries, causing significant morbidity and mortality [1]. Although some fracture patterns are stable enough requiring only conservative treatment, other fracture types can cause significant pelvic instability, demanding a more insistent management protocol.
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