Comparison of anterior internal fixator and external fixator for treatment of anterior pelvic ring fracture / 中华创伤骨科杂志

ABSTRACT

Objective To compare the therapeutic effects between anterior internal fixator (INFIX) and external fixator (EXFIX) for anterior pelvic ring fracture.Methods A retrospective study was conducted on the 66 patients with anterior pelvic ring fracture who had been treated surgically from January 2016 to June 2017 at Department of Spinal Surgery,Hospital Affiliated to Southwest Medical University and at Department of Orthopedics,Union Hospital Affiliated to Tongji Medical College.They were divided into an observation group and a control group according to their fixation of the anterior pelvic ring.In the observation group of 33 cases fixated with INFIX,there were 20 males and 13 females,aged from 32 to 47 years (38.8 ±4.8 years).By the Tile's classification,15 of them belonged to type B and 18 to type C.In the control group of another 33 patients fixated with EXFIX,there were 19 males and 14 females,aged from 33 to 48 years (39.5 ±4.6 years).By the Tile's classification,14 of them belonged to type B and 19 to type C.The 2 groups were compared in terms of postoperative fracture reduction,pelvic function and complications.Results The 66 patients were followed up for an average of 13.7 months(from 12 to 18 months).According to the Matta criteria for fracture reduction,21 cases were excellent,9 good,2 fair and one poor in the observation group (excellent and good rate90.9％);18 cases were excellent,8 good,5 fair and 2 poor in the control group (excellent and good rate78.8％).The difference was statistically significant between the 2 groups (P ＜ 0.05).The pelvic function assessed by the Majeed criteria at the final follow-up was excellent in 21 cases,good in 10,fair in one and poor in one in the observation group (excellent and good rate93.9％);it was excellent in 17 cases,good in 9,fair in 4 and poor in 3 in the control group (excellent and good rate78.8％).The difference was also statistically significant between the 2 groups (P ＜ 0.05).The incidence of injury to the lateral femoral cutaneous nerve was 9.1％ (3/33) for the observation group and 6.1％ (2/33) for the control group,showing no significant difference between the 2 groups (P ＞ 0.05).The incidences of screw loosening and pin track infection were significantly lower in the observation group than in the control group[0 versus 24.2％ (8/33) and 0 versus 18.2％ (6/33),respectively] (both P ＜ 0.05).Conclusion Compared with EXFIX,INFIX can lead to better clinical outcomes and fewer operative complications in the treatment of anterior pelvic ring fractures.