Minimally invasive treatment of unstable pelvic fractures with blunt head technique of Kirschner wire and 3D-printed external template technigue
10.3760/cma.j.cn115530-20220310-00139
- VernacularTitle:克氏针钝头技术联合3D打印体外导板技术微创治疗不稳定型骨盆骨折的疗效分析
- Author:
Yizhou WAN
1
;
Kaifang CHEN
;
Sheng YAO
;
Yulong WANG
;
Lian ZENG
;
Tingfang SUN
;
Xiaodong GUO
Author Information
1. 华中科技大学同济医学院附属协和医院骨科，武汉 430022
- Keywords:
Pelvis;
Fractures, bone;
Surgical procedures, minimally invasive;
3D-printed technology;
Blunt head;
External template
- From:
Chinese Journal of Orthopaedic Trauma
2022;24(12):1024-1029
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and efficacy of the minimally invasive treatment of unstable pelvic fractures with the blunt head technique of Kirschner wire and 3D-printed external template technique.Methods:A retrospective study was conducted of the clinical data of 21 patients with unstable pelvic fracture who had undergone minimally invasive treatment at Department of Orthopaedics, Union Hospital from May 2016 to July 2018 using 3D-printed external templates and the blunt head technique of Kirschner wire. There were 7 males and 14 females with an age of 43.6 years (from 19 to 65 years). According to the Tile classification, there were 3 cases of B1, 7 ones of B2, 6 ones of C1 and 5 ones of C2. The intraoperative fluoroscopy, operation time, postoperative fracture reduction and functional recovery of the pelvis at the last follow-up were recorded.Results:The 21 patients were followed up for an average of 16.3 months (from 12 to 24 months). A total of 33 wires were inserted in the 21 patients, including 15 S 1 ones and 18 S 2 ones. The intraoperative fluoroscopy ranged from 13 to 27 times, averaging 21.8 times. The operation time ranged from 65 to 130 min, averaging 88.6 min. The anterior subcutaneous internal fixation was used to fix the anterior ring in 9 patients. No vascular injury occurred during the operation. By the Matta criteria, the postoperative fracture reduction was assessed as excellent in 14 cases, good in 5, and fair in 2, giving an excellent to good rate of 90.5% (19/21). By the Majeed scoring system, the pelvic function at the last follow-up was assessed as excellent in 10 cases, good in 8, and fair in 3, giving an excellent to good rate of 85.7% (18/21). Lateral femoral cutaneous nerve injury occurred in 2 patients but was recovered by the 3-month follow-up. No other complications were follwed up. Conclusion:The minimally invasive treatment of unstable pelvic fractures with the blunt head technique of Kirschner wire assissted by 3D-printed external templates is safe and effective, showing advatages of reduced fluoroscopic frequency and operation time.
