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Treatment of Tile type C3 pelvic fracture with iliolumbar fixation combined with internal fixation and plate fixation in obese patients / 中华创伤杂志
Chinese Journal of Trauma ; (12): 810-815, 2020.
Article in Chinese | WPRIM | ID: wpr-867781
ABSTRACT

Objective:

To explore the clinical effect of iliolumbar fixation combined with internal fixation (INFIX) and plate fixation in treatment of Tile type C3 pelvic fracture in obese patients.

Methods:

A retrospective case series study was conducted to analyze the data of 14 obese patients with Tile type C3 pelvic fracture admitted to Shandong Provincial Hospital from March 2014 to June 2019, including 10 males and 4 females, aged 14-46 years [(37.1±8.9)years]. The body mass index was 28.0-38.6 kg/m 2 [(30.7±3.4)kg/m 2]. All patients were treated by posterior iliolumbar fixation, followed by INFIX and plate fixation in the anterior ring. The operation time, intraoperative blood loss, and fracture healing time were observed. The visual analogue scale (VAS) was used to evaluate the improvement of limb pain before operation, immediately after operation, at postoperative 3 months and 6 months, and at last follow-up. The fracture reduction was evaluated by Matta criteria, and function was evaluated by Majeed functional score at last follow-up. Postoperative complications were observed.

Results:

All patients were followed up for 6-18 months [(13.5±4.0)months]. The operation time was 4-10.5 hours [(6.9±2.3)hours], and the intraoperative blood loss was 800-2 200 ml [(1 071.4±357.4)ml]. All fractures were healed at 12-32 weeks [(19.1±5.9)weeks]. The VAS was (8.2±1.0)points preoperatively, (5.9±0.8)points immediately after surgery, (3.9±0.9)points, (3.0±0.8)points and (1.9±1.1)points respectively at postoperative 3 months and 6 months, and at last follow-up (all P<0.01). At last follow-up, according to the Matta criteria, the results were excellent in 10 patients, good in 2, fair in 1, poor in 1, with the excellent and good rate of 86%. At last follow-up, the results for Majeed functional score were excellent in 8 patients, good in 3, fair in 2 and poor in 1, with the excellent and good rate was 79%. One patient had venous thrombosis of lower extremities, with good therapeutic effect after anticoagulation therapy. Two patients had lateral femoral cutaneous nerve injury and recovered gradually after the internal fixation was removed.

Conclusions:

Iliolumbar fixation combined with INFIX plus plate fixation in the treatment of obese patients with Tile type C3 pelvic fracture has the advantages of good fracture healing, pain relief, satisfactory pelvic reduction and function recovery, and less postoperative complications. The procedure is an alternative surgical plan for treatment of Tile type C3 pelvic fracture in obese patients.
Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Trauma Year: 2020 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Trauma Year: 2020 Type: Article