Combined Pelvic Ring Disruption and Acetabular Fracture: Outcomes Using a Sequential Reduction Protocol and an Anterior Subcutaneous Pelvic Fixator (INFIX)
| Autor: | Kevin Blue, Fred Tonnos, Bryant Oliphant, Rahul Vaidya |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Fractures Multiple Radiography Fracture Fixation Internal Fractures Bone Young Adult 03 medical and health sciences Injury Severity Score 0302 clinical medicine Infix Clinical Protocols Pelvic ring medicine Humans Orthopedics and Sports Medicine Pelvic Bones Aged Retrospective Studies 030222 orthopedics Sciatic nerve palsy business.industry Trauma center Acetabular fracture Acetabulum 030208 emergency & critical care medicine Prostheses and Implants General Medicine Middle Aged medicine.disease Surgery Female Heterotopic ossification business |
| Zdroj: | Journal of Orthopaedic Trauma. 33:S66-S71 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000001416 |
| Popis: | Objective The purposes of this article were to (1) compare our combined pelvic ring and acetabular fracture patients' rate of mortality and Injury Severity Score (ISS) to those of patients with isolated injuries at our center and to those with combined injuries as reported in the literature, (2) describe our treatment algorithm using the INFIX for these combination injuries, and (3) report our patients' radiographic and functional outcomes. Design Retrospective IRB-approved case series and literature review. Setting US Level 1 Trauma Center. Patients/participants Thousand six hundred ninety-seven with acetabular or pelvic ring injury, 174 patients with combination pelvic ring acetabular injuries, and 39 patients with 41 acetabular injuries treated with a surgical protocol. Intervention Pelvic ring reduction using INFIX and posterior fixation followed by acetabular reduction fixation. Anterior injury fixed with INFIX. Main outcome Mortality, ISS, pelvic reduction by Keshishyan index, acetabular reduction by the Matta criteria, and functional outcome by the Majeed score. Results Mortality was 5.7% and ISS was 12.5 for 174 combined injury patients. In the 39 patients with 41 injuries, excellent pelvic reduction was found in 39, and acetabular reduction was anatomic in 25 (61%), imperfect in 12 (29%), and poor in 4 (10%). Clinically 78% of the patients had good or excellent outcome and 22% had a fair or poor outcome. Nonanatomic acetabular reduction, persistent sciatic nerve palsy, and heterotopic ossification associated with poor clinical outcome. Conclusions Our treatment protocol resulted in excellent pelvic reduction, anatomic acetabular reduction in 61% of patients, and 78% good to excellent clinical outcome. Level of evidence Case series Level IV. |
| Databáze: | OpenAIRE |
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