Chirurgie mini-invasive pour le traitement des fractures instables en cisaillement de l’anneau pelvien avec déplacement vertical important : une étude rétrospective - 29/01/23

Minimally invasive surgery technique for unstable pelvic ring fractures with severe vertical shear displacement: A retrospective study

Doi : 10.1016/j.rcot.2022.12.022

Takuya Morita ^a,⁎ , Tomoyuki Takigawa ^a, Takeshi Ishihara ^a, Takuya Taoka ^a, Takahiko Ishimaru ^a, Tomoko Kanazawa ^a, Keitaro Tada ^b, Takao Omori ^a, Yukihisa Yagata ^b, Kazukiyo Toda ^a, Kie Nakago ^a, Yasuo Ito ^a
^a Department of Orthopedic Surgery, Kobe Red Cross Hospital, 1-3-1, Wakihamakaigandori, Chuo-ku, 651-0073 Kobe City, Hyogo, Japon
^b Department of Orthopedic Surgery, Hyogo Emergency Medical Center, 1-3-1, Wakihamakaigandori, Chuo-ku, 651-0073 Kobe City, Hyogo, Japon

^⁎Auteur correspondant.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 29 January 2023
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Abstract

Background

Unstable pelvic fractures, especially vertical shear fractures, require surgery for correct reduction, rigid fixation, and improved postoperative outcomes. Herein, we assess the effectiveness of our minimally invasive procedure for the management of unstable pelvic fractures.

Hypothesis

We hypothesized that this procedure would be useful for the management of unstable pelvic fractures.

Patients and methods

This study included 28 patients with unstable pelvic fractures (vertical shear injuries; AO types C1–3) treated using minimally invasive surgery for spinopelvic fixation (MIS-SP) between 2014 and 2020 (mean follow-up time, 15 months). The MIS-SP requires four percutaneous pedicle screws and four iliac screw insertions. Subsequently, reduction and fixation are performed.

Results

The mean preoperative displacement of the posterior pelvic elements in craniocaudal correction was 17.6 (range: 9.0–32.2) mm. The mean length of the craniocaudal reduction was 16.5 (8.1–30.1 mm), with a mean reduction rate of 93.5% (78–100%). The mean length of the mediolateral reduction was 11.3 (3.9–19.6 mm), with a mean reduction rate of 87.3% (76–100%).

Discussion

Our novel reduction and fixation procedure is a powerful, minimally invasive option for the treatment of unstable pelvic ring fractures.

Level of evidence

III.

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Keywords : Pelvis, Minimally invasive surgery, Fracture fixation, Closed Fracture reduction, Pelvic fractures, Vertical shear fractures

Plan

Abréviations

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.