Objective To evaluate the clinical effect of 3D printing-assisted percutaneous screw fixation in treating unstable pelvic fracture.Methods A total of 80 patients with unstable pelvic fractures,who received treatment at the Lianyungang Municipal First People's Hospital of China from January 2022 to January 2023,were enrolled in this study.According to the surgical methods,the patients were divided into percutaneous screw fixation group(n=47,receiving 3D printing-assisted percutaneous screw fixation)and open reduction group(n=33,receiving open reduction with steel plate internal fixation).The intraoperative blood loss,time spent for surgery,total hospitalization time,fracture healing time,levels of serum creatine kinase(CK),myoglobin(Myo),lactate dehydrogenase(LDH)levels,and incidence of surgical complications were compared between the two groups.Results In the percutaneous screw fixation group,the time spent for surgery[(62.96±19.31)min vs(100.07±26.71)min],intraoperative blood loss[(112.71±25.43)mL vs(230.65±30.29)mL],total hospitalization time[(11.04±2.35)days vs(15.16±2.58)days]and fracture healing time[(102.18±9.74)days vs(113.42±11.52)days]were remarkably higher than those in the open reduction group(all P＜0.01);the postoperative 3-month total effective rate was 95.74％,which was significantly higher than 80.00％in the open reduction group(P＜0.05);and the excellent rate of fracture reduction quality was higher than that in the open reduction group(P＜0.05).The postoperative one-,3-and 6-month Majeed scores in the percutaneous screw fixation group were strikingly higher than those in the open reduction group(all P＜0.05).No statistically significant differences in the preoperative levels of CK,Myo and LHD existed between the two groups(all P＞0.05),while the postoperative levels of CK,Myo and LHD in the percutaneous screw fixation group were prominently lower than those in the open reduction group(all P＜0.05).The difference in the incidence of postoperative complications between the two groups was not statistically significant(P＞0.05).Conclusion For the treatment of unstable pelvic fracture,3D printing-assisted percutaneous screw fixation is superior to open reduction with plate internal fixation in achieving better clinical results,reducing surgical injury,and shortening postoperative recovery time.

Objective:To compare the efficacy of internal fixation and external fixation in the treatment of pelvic fractures.Methods:A retrospective case control study was conducted to analyze the data of 66 patients with anterior pelvic ring fracture treated from December 2015 to December 2017 at First People's Hospital of Lianyungang, including 36 males and 30 females, with an average age of 42.7 years (range, 19 to 63 years). There were 36 patients with Tile type B fractures and 30 with Tile type C fractures. Minimally invasive percutaneous internal fixation through the anterior inferior iliac spine was performed in 33 patients (internal fixation group) and external fixator was employed in another 33 patients (external fixation group). The two groups were compared in terms of the operation time, intraoperative blood loss, fracture healing time, fracture reduction assessment with Matta criteria, Majeed score and surgical complications.Results:All patients were followed up for 9-24 months (mean, 14.5 months). The operation time was (33.7±3.6)minutes in internal fixation group , and (24.5±3.5)minutes in external fixation group ( P<0.05). Intraoperative blood loss was (25.8±3.3)ml in internal fixation group and (21.8±4.3)ml in external fixation group ( P<0.05). The fractures were healed acceptably, with the healing time of (13.8±1.6)weeks in internal fixation group and (21.7±1.9)weeks in external fixation group ( P< 0.05). According to the Matta criteria, internal fixation group showed excellent results in 17 patients, good in 14, fair in 2 and poor in 0, with the excellent and good rate of 94%; external fixation group showed excellent results in 14 patients, good in 12, fair in 6 and poor in 1 , with the excellent and good rate of 79% ( P>0.05). For Majeed function score, the results in internal fixation group were excellent in 18 patients, good in 13, fair in 2 and poor in 0, with the excellent and good of 94%; the results in external fixation group were excellent in 14 patients, good in 12, fair in 7 and poor in 0, with the excellent and good of 79% ( P>0.05). After operation, frequent urinary occurred in one patient, unilateral femoral nerve partial paralysis in one, nail cap stimulation in two and incisional redness, swelling and exudation in one in internal fixation group. In external fixation group, there were 5 patients with nail rod exudation. Conclusion:Compared with the external fixator, the internal fixation for pelvic fractures is less invasive and more reliable, can accelerate fracture healing without interfering with the patient's daily life, and can be used as the final fixation.