Curative effect of percutaneous screw-rod system combined with sacroiliac screw internal fixation in the treatment of types II-IV fragility fracture of the pelvis
10.3760/cma.j.cn501098-20220920-00627
- VernacularTitle:经皮钉棒系统联合骶髂螺钉内固定与非手术治疗Ⅱ~Ⅳ型骨盆脆性骨折的疗效比较
- Author:
Shuqing ZHOU
1
;
Hui LU
;
Xiaohua ZHANG
;
Guiyong QIN
;
Wen ZOU
;
Chengguang WANG
Author Information
1. 重庆市江津区中心医院骨科，重庆 402260
- Keywords:
Pelvis;
Osteoporosis;
Fracture fixation, internal;
Minimally invasive
- From:
Chinese Journal of Trauma
2023;39(1):47-54
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effect of percutaneous screw-rod system combined with sacroiliac screw internal fixation and non-operation of type II-IV fragility fracture of the pelvis (FFP).Methods:A retrospective multicentral cohort study was performed to analyze the clinical data of 74 patients with FFP treated in Jiangjin Central Hospital of Chongqing and Hechuan People′s Hospital of Chongqing from January 2017 to June 2021, including 23 males and 51 females, aged 62-95 years [(79.3±7.3)years]. A total of 41 patients received non-surgical treatment (non-operation group). and 33 patients received percutaneous screw-rod system combined with sacroiliac screw internal fixation (operation group). The time to get out of bed, visual analog scale (VAS) and Majeed score on admission and at 1, 3, 6, 12 months after treatment, fracture healing time and complications were evaluated in the two groups.Results:Except for 9 patients who died at 3-9 months after treatment, the remaining patients were followed up for 12-24 months [(13.5±3.2)months]. The time to get out of bed was (11.4±2.8)days in operation group and was (67.4±4.4)days in non-operation group ( P<0.01). The VAS and Majeed score at 1, 3, 6 and 12 months after treatment were significantly improved in both groups compared with those on admission (all P<0.05). There was no significant difference in VAS and Majeed score between the two groups on admission (all P>0.05). The VAS was (3.2±0.7)points in operation group compared to (4.2±0.8)points in non-operation group at 1 month after treatment, and was (1.8±0.5)points in operation group compared to (2.9±0.7)points in non-operation group at 3 months after treatment (all P<0.01). The Majeed score was (56.0±2.4)points in operation group compared to (40.4±2.7)points in non-operation group at 1 month after treatment; the score was (77.3±2.6)points in operation group compared to (57.7±4.2)points in non-operation group at 3 months after treatment; the score was (86.5±1.8)points in operation group compared to (79.6±2.8)points in non-operation group at 6 months after treatment (all P<0.01). In contrast, the two groups had no statistically significant difference in VAS at 6 months and 12 months after treatment and Majeed score at 12 months after treatment (all P>0.05). There was no statistically significant difference in the fracture healing time between the two groups ( P>0.05). There was no statistically significant difference in the incidence of complications related to fixation methods between the two groups ( P>0.05). The incidence of bed-related complications was 24.2% (8/33) in operation group and was 51.2% (21/41) in non-operation group ( P<0.05). The 1-year fatality rate was 3.0% (1/33) in operation group and 19.5% (8/41) in non-operation group ( P<0.05). Conclusion:Compared with non-operative treatment, percutaneous screw-rod system combined with sacroiliac screw internal fixation in the treatment of type II-IV FFP can allow early off-bed movement, effectively relieve pain, improve quality of life of the patients, and reduce complication rate.
