Efficacy of Percutaneous Sacroiliac Screws Combined With Retrograde Pubic Ramus Screws in the Treatment of Unstable Pelvic Fractures
10.3969/j.issn.1009-6604.2025.04.004
- VernacularTitle:经皮骶髂螺钉联合逆行耻骨支螺钉治疗不稳定型骨盆骨折的疗效
- Author:
Wei CUI
1
;
Yuliang SUN
1
;
Jing LIU
1
;
Tao GU
1
;
Huagang SHI
1
;
Xuangeng DENG
1
Author Information
1. 四川省骨科医院脊柱科,成都 610041
- Publication Type:Journal Article
- Keywords:
Pelvic fracture;
Internal fixation of fractures;
Screw;
Minimally invasive surgery
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(4):210-215
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the safety and efficacy of percutaneous sacroiliac screw combined with retrograde pubic ramus screws in the treatment of unstable pelvic fractures.Methods A retrospective analysis was made on clinical data of 32 cases of unstable pelvic fractures treated with percutaneous sacroiliac screws combined with retrograde pubic ramus screws from August 2021 to November 2023.The channel screws were inserted under the guidance of C-arm fluoroscopy.Results A total of 75 channel screws were inserted,including 36 sacroiliac screws and 39 retrograde pubic ramus screws.Each sacroiliac screw underwent fluoroscopy for(32.2±4.6)times,and each pubic ramus screw for(40.3±11.7)times.The operation time was(154.2±43.8)min,and the intraoperative blood loss was(30.5±8.7)ml.There were no iatrogenic vascular or nerve injuries.One case of pubic ramus screw infection occurred after surgery,and a debridement was performed to remove internal fixation.All the fractures had bone union,and the healing time was(13.2±3.7)weeks.The quality of fracture reduction(Matta criteria)was excellent in 27 cases,good in 3 cases,and fair in 2 cases,with an excellent and good rate of 93.8%(30/32).CT images showed the penetration of 73 screws at level 0,1 screw at level 1,and 1 at level 2.All the 32 cases were followed up for 6-42 months(mean,16.3±6.1 months).According to the Majeed functional scoring criteria,28 cases were excellent,3 cases were good,and 1 case was fair,with an excellent and good rate of 96.9%(31/32).Conclusion Percutaneous sacroiliac screws combined with retrograde pubic ramus screws in the treatment of unstable pelvic fractures is easy to operate and safe,and has satisfactory therapeutic effects.