ABSTRACT
BACKGROUND: The aim of this study is to compare the clinical and biomechanical outcome of INFIX plus single with two sacroiliac screw fixation for unstable pelvic fractures of Type C. METHODS: Sixteen cadavers were randomly subjected to INFIX plus single or double sacroiliac screw fixations and then mounted onto the ElectroForce loading machine under different vertical loads. To investigate the clinical outcomes of the two techniques, nineteen patients were retrospectively analyzed. The main outcome measures were postoperative radiographic reduction grading (using the Tornetta and Matta grading system), functional outcome (using the Majeed scoring system), and incidence of complications. RESULTS: In the biomechanical study, INFIX plus double sacroiliac screw fixation showed better biomechanical stability than fixation with a single sacroiliac screw (p < 0.05). In our clinical case series, all 19 patients had bony union 6 months after the operation. INFIX plus double sacroiliac screw fixation also demonstrated a better functional outcome and a higher radiographic satisfactory rate than INFIX plus single sacroiliac screw fixation (79.25 ± 5.47; 91.33 ± 4.97; p < 0.05), (77.78% vs. 60%; p = 0.05). One patient in INFIX plus single-screw fixation group had screw loosening at 6-month follow-up postoperatively. One case in each group suffered heterotopic ossification and the lateral femoral cutaneous nerve paralysis, and one patient suffered from infection. CONCLUSION: INFIX plus double sacroiliac screw fixation demonstrated more stability in cadaveric biomechanical analysis and better clinical outcomes than INFIX plus single sacroiliac screw fixation.
Subject(s)
Fractures, Bone , Pelvic Bones , Bone Screws , Fracture Fixation, Internal/methods , Fractures, Bone/diagnostic imaging , Fractures, Bone/surgery , Humans , Pelvic Bones/diagnostic imaging , Pelvic Bones/injuries , Pelvic Bones/surgery , Retrospective StudiesABSTRACT
OBJECTIVE: To evaluate the imaging efficacies after Salter innominate osteotomy for developmental dysplasia of the hip (DDH). METHODS: A total of 51 DDH patients with 70 hips were recruited between March 2011 to August 2012. All of them underwent Salter innominate osteotomy. Preoperative radiographs including acetabular index (AI), sharp angle (SA), obturator angle and obturator height were measured. And postoperative radiographs were taken at 2 days, 3 months, 6 months and 1 year to measure the parameters of AI, sharp acetabular angle, obturator angle, obturator height, shifting index and descending angle of distal iliac end. Paired t test was used for statistical analyses. RESULTS: The average correction of AI was 35.5° ± 2.3° preoperatively versus 14.6° ± 1.6° postoperatively ( P = 0.000) . The average correction of Sharp angle was 50.6° ± 3.7° preoperatively versus 33.1° ± 3.2° postoperatively (P = 0.000) . The average correction of obturator angle was 58.3° ± 3.9° preoperatively versus 39.5° ± 2.8° postoperatively (P = 0.000) . The average correction of obturator height was (1.65 ± 0.26) cm preoperatively versus (1.10 ± 0.14) cm postoperatively (P = 0.000) . At 3 months, 6 months and 1 year post-operation, the average values of AI, SA, obturator angle and obturator height continued to fall. Both of them showed statistical improvement. Shifting index and descending angle of distal iliac end were 30.1% ± 3.6% and 31.3° ± 4.1° on average. Six (8.57%) Shenton lines were bad. CONCLUSIONS: The imaging evaluations of acetabulum and pelvis show marked improvements until 1 year in DDH patients after Salter innominate osteotomy. It provides data reference for operative evaluations through measuring the imaging parameters of truncation bone.
