Endoscopic-assisted anterior pelvic ring osteosynthesis for pelvic ring injuries: a technical report.

Autor: Lai CY; Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan, 33302, Taiwan., Chen IJ; Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan, 33302, Taiwan., Lai PJ; Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan, 33302, Taiwan., Hsu YH; Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan, 33302, Taiwan., Chou YC; Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan, 33302, Taiwan., Ueng SWN; Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan, 33302, Taiwan. wenneng@adm.cgmh.org.tw.; Department of Orthopedic Surgery, Musculoskeletal Research Center, Linkou Branch, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsin St. Kweishan, Tao-Yuan, 33302, Taiwan. wenneng@adm.cgmh.org.tw., Yu YH; Division of Orthopedic Traumatology, Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan, 33302, Taiwan. alanyu1007@gmail.com.; Department of Orthopedic Surgery, Musculoskeletal Research Center, Linkou Branch, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsin St. Kweishan, Tao-Yuan, 33302, Taiwan. alanyu1007@gmail.com.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2024 Dec 12; Vol. 145 (1), pp. 30. Date of Electronic Publication: 2024 Dec 12.
DOI: 10.1007/s00402-024-05634-6
Abstrakt: Introduction: In the surgical treatment of pelvic ring injuries (PRIs), there is an increasing adoption of minimally invasive techniques to improve surgical outcomes. Since the introduction of endoscopic-assisted osteosynthesis for PRIs in 2019, various surgical challenges have been identified. To improve surgical and clinical outcomes, we modified the existing procedures and aimed to present the surgical outcomes of patients with pelvic fractures who underwent endoscopic-assisted surgery.
Materials and Methods: We conducted a retrospective analysis of patients with PRIs treated with endoscopic technique over a 15-month period. All patients were diagnosed with diastatic symphysis, superior pubic ramus fracture, or both. The postoperative radiological and functional outcomes were assessed and reported. Details of the preoperative planning and surgical procedures were reviewed.
Results: Thirteen patients with PRIs were enrolled: 10 patients for diastatic pubic symphysis (three of whom received superior ramus screw fixation) and three for isolated superior pubic ramus fractures. All surgeries were completed with endoscopic assistance, without the need for conversion to open surgery. The average surgical duration was 204.1 min, the endoscopy time was 103.7 min, and the volume of blood loss was 185.0 ml. Excellent reduction was achieved in all patients according to the Matta/Tornetta criteria and in nine patients according to the Lefaivre criteria. The mean Majeed scores were 71 and 82 and the mean Merle d'Aubigné scores 11 and 15 at 3 and 6 months postoperatively, respectively.
Conclusion: Endoscopic-assisted pelvic surgery is a safe and effective treatment alternative for PRIs, particularly when focusing on the anterior pelvic ring. The advantages of this approach, including small incisions and preservation of abdominal and pelvic floor muscle integrity, contribute to improved patient recovery. Future research should focus on comparative studies of this technique with other minimally invasive techniques and open surgery.
Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: This study was performed in accordance with the principles of the Declaration of Helsinki. This study was approved by the Institutional Review Board of Chang Gung Memorial Hospital (IRB No: 202401217B0). Consent to participate: The requirement for informed consent was waived owing to the retrospective nature of the study. Consent for publication: Not applicable.
(© 2024. The Author(s).)
Databáze: MEDLINE
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