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Tytuł:
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Iliosacral screw fixation of pelvic ring disruption with tridimensional patient-specific template guidance.
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Autorzy:
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Liu F; Department of Orthopedics, The 3rd Hospital of Changsha, Hunan, P.R. China.
Yu J; Department of Orthopedics, Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital Central South University, 87 Xiangya Road, Changsha, Hunan, 410007, P.R. China.
Yang H; Department of Orthopedics, The 3rd Hospital of Changsha, Hunan, P.R. China.
Cai L; Department of Radiology, the 3(rd) Hospital of Changsha, 3D Printing Institute for Medical Application of Changsha, P.R. China.
Chen L; Department of Orthopedics, The 3rd Hospital of Changsha, Hunan, P.R. China.
Lei Q; Department of Orthopedics, The 3rd Hospital of Changsha, Hunan, P.R. China.
Lei P; Department of Orthopedics, Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital Central South University, 87 Xiangya Road, Changsha, Hunan, 410007, P.R. China. Electronic address: .
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Źródło:
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Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2022 Apr; Vol. 108 (2), pp. 103210. Date of Electronic Publication: 2022 Jan 22.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: Issy les Moulineaus, France : Elsevier Masson SAS,
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MeSH Terms:
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Fracture Dislocation*
Fractures, Bone*/diagnostic imaging
Fractures, Bone*/etiology
Fractures, Bone*/surgery
Joint Dislocations*/diagnostic imaging
Joint Dislocations*/etiology
Joint Dislocations*/surgery
Pelvic Bones*/diagnostic imaging
Pelvic Bones*/injuries
Pelvic Bones*/surgery
Spinal Fractures*/etiology
Blood Loss, Surgical ; Bone Screws/adverse effects ; Fracture Fixation, Internal/methods ; Humans ; Pelvis ; Retrospective Studies ; Sacrum/diagnostic imaging ; Sacrum/injuries ; Sacrum/surgery
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Contributed Indexing:
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Keywords: Guide template; Stabilization; Three dimensional printing technique; Unstable pelvic fracture
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Entry Date(s):
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Date Created: 20220125 Date Completed: 20220419 Latest Revision: 20220606
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Update Code:
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20240105
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DOI:
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10.1016/j.otsr.2022.103210
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PMID:
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35077898
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Introduction: Posterior pelvic ring disruption includes sacral fractures, sacroiliac joint fracture dislocations and ilium fractures. Percutaneous iliosacral screw fixation of sacral fractures and sacraoiliac joint fracture dislocations have been prevailing, it has the advantages of minimal invasiveness, less blood loss and low wound infection rate.
Hypothesis: This study was to evaluate the application of three-dimensional (3D) printed patient-specific guide template in closed reduction and iliosacral screw fixation of posterior pelvic ring disruption.
Material and Methods: The data of patients, who were treated with closed reduction and iliosacral screw fixation of posterior pelvic ring disruption with the assistance of 3D printed guide template from December 2014 to September 2018, were collected. The screw placement time, fluoroscopy time, intraoperative blood loss, fracture reduction, screw position, and functional assessment were recorded.
Results: There were 17 cases of unstable pelvic fractures,and 20 screws were inserted for fixation of sacral fractures or sacroiliac joint dislocations, with bilateral screw placement in 3 cases. The average time for each screw placement was 45.9±8.6min (30-60min). The average fluoroscopy time for each screw insertion was 50.3±19.7s (24-96 s). The mean blood loss for each screw placement was 32.0±11.1ml (20-50ml). According to Matta scale, the fracture reduction was graded as excellent in all the 17 cases. According to the modified Gras classification, the 3D CT reconstruction of the pelvis demonstrated Grade 1 for 18 screws and Grade 2 for 2 screw. Functional outcome 1 year postoperatively was rated as 15 excellent and 2 good, according to the Majeed functional scale.
Discussion: It is feasible and safe to stabilize the posterior pelvic ring disruption using iliosacral screw fixation under assistance of the 3D printed guide template. It could reduce fluoroscopy time, screw placement time and intraoperative blood loss and achieve good postoperative recovery.
Level of Proof: IV; Retrospective study.
(Copyright © 2022 Elsevier Masson SAS. All rights reserved.)
