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Results of open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable pelvic ring injuries: retrospective study of 36 patients

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Abstract

Introduction

Surgical stabilization of posterior pelvic ring fractures can be achieved by closed reduction and percutaneous fixation (CRPF) or by open reduction and internal fixation (ORIF). The aim of the present study is to compare the clinical results of both methods.

Material and methods

Medical records of 36 patients consecutively operated for unstable pelvic ring injuries were retrospectively reviewed. We compared 22 patients treated with CRPF versus 14 patients stabilized by using ORIF between 2007 and 2017. The Majeed and Pohlemann scores were used to evaluate postoperative functional outcomes. Complications like blood loss, infection rate, Neurological injury, the operative time and the length of hospital stay were analyzed.

Results

The median Majeed pelvic score was 87 points for the CRPF technique compared with 69 points for the ORIF technique. The median Pohlemann score, operative time and length of hospitalization were similar between the two groups. The median blood loss for the CRPF technique was 300 ml compared to 500 ml for the ORIF technique. CRPF and ORIF procedure had each one neurological lesion. There was one case of infection in the ORIF group and none in the CRPF group. No measurements except for the blood loss have reached the significance threshold.

Conclusion

The CRPF technique shows a clear decrease in blood loss. There was no statistically significant difference in the functional results, infection rate, neurological injury, operative time and hospital stay between both techniques.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Sami Abou-Khalil, Sylvain Steinmetz, Laurent Mustaki, Eric Thein & Olivier Borens

  2. Institute for Research in Rehabilitation, Clinique Romande de Réadaptation Suvacare, Avenue Grand-Champsec 90, 1950, Sion, Switzerland

    Bertrand Leger

Authors
  1. Sami Abou-Khalil
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  2. Sylvain Steinmetz
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  3. Laurent Mustaki
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  4. Bertrand Leger
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  5. Eric Thein
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  6. Olivier Borens
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Correspondence to Sylvain Steinmetz.

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All authors declare that they have no conflict of interest.

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The ethics committee approved the study (2017-02091).

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Abou-Khalil, S., Steinmetz, S., Mustaki, L. et al. Results of open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable pelvic ring injuries: retrospective study of 36 patients. Eur J Orthop Surg Traumatol 30, 877–884 (2020). https://doi.org/10.1007/s00590-020-02646-x

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  • DOI: https://doi.org/10.1007/s00590-020-02646-x

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