Internal fixation with pubic nails and sacroiliac screws aided by 3D navigation for pelvic fractures of Tile type B2 or B3
10.3760/cma.j.issn.1671-7600.2017.08.006
- VernacularTitle:3D导航辅助下前柱螺钉联合骶髂关节螺钉内固定治疗Tile B2、B3型骨盆骨折
- Author:
Long CHEN
;
Guodong WANG
;
Ximing LIU
;
Xianhua CAI
- Keywords:
Pelvis;
Fractures;
bone;
Fracture fixation;
internal;
Bone nails;
Surgery;
computer-assisted
- From:
Chinese Journal of Orthopaedic Trauma
2017;19(8):675-679
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the clinical effects of internal fixation with pubic nails and sacroiliac screws aided by 3D navigation for pelvic fractures of Tile type B2 or B3. Methods A total of 27 patients with pelvic fracture of Tile type B2 or B3 received operative treatment in our hospital from De-cember 2013 to December 2016. They were 15 men and 12 women, aged from 20 to 68 years ( average, 39. 2 years ) . According to the Tile classification, 12 cases were type B2. 1, 8 type B2. 2, and 7 type B3. Of them, 20 were unilateral pubic rami fractures and 7 bilateral pubic rami fractures; there were 3 dislocations of the sacroiliac joint, 17 fractures of the sacral Denis regionⅠ, and 7 fractures of the sacral Denis regionⅡ. All the 27 cases were treated by internal fixation with retrograde pubic nails and sacroiliac screws aided by 3D navi-gation. Quality of fracture reduction, functional recovery of the pelvis and postoperative complications were recorded to evaluate the clinical effects. Results Totally 26 out of the 27 patients were followed up for 6 to 18 months ( average, 11. 4 months ) , with one lost to the follow-up. According to the Matta scoring, the pelvic reduction was evaluated as excellent in 20, as good in 4 and as fair in 2 cases, yielding an excellent and good rate of 92. 3％. All the fractures united after 12 to 20 weeks ( average, 13. 8 weeks ) . According to the Majeed scoring at the final follow-ups, the pelvic function was evaluated as excellent in 20, as good in 3 and as fair in 3 cases, giving an excellent and good rate of 88. 5％. Screw loosening happened in one patient who had ambulated too early. No permanent pain, wound infection, neurovascular injury, heterotopic ossification or thrombosis occurred. Conclusion For the treatment of pelvic fractures of Tile type B2 or B3, internal fixation with pubic nails and sacroiliac screws aided by 3D navigation can lead to satisfactory short-term outcomes due to advantages of limited operative invasion, short operation time and limited intraoperative blood loss.
