The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures o...The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures of 3DPS were introduced.A retrospective analysis was performed on 49 patients with sacroiliac complex injury from March 2013 to May 2017.Twenty-one cases were treated by 3DPS,and 28 cases by MIRP.Intraoperative indexes as operative time,blood loss,incision length,length of hospital stay and postoperative complications were respectively documented.Quality of reduction was postoperatively evaluated by Matta radiological criteria,and clinical effect was assessed by Majeed scoring criteria at the last followup.Operative time and hospital stay were significantly shortened,and blood loss,and incision length were significantly reduced in 3DPS group as compared with those in MIRP group(P<0.05).No statistically significant difference was found between 3DPS group and MIRP group in the assessment of reduction and function(P>0.05).It was concluded that both 3DPS and MIRP can effectively treat the sacroiliac complex injury,and 3DPS can provide an accurate,safe and minimally invasive fixation with shorter operative time and hospital stay.展开更多
Purpose The fixation method commonly employed worldwide for treating unstable fractures of the posterior pelvic ring is the percutaneous iliosacral screw technique.However,prolonged operation time and frequent fluoros...Purpose The fixation method commonly employed worldwide for treating unstable fractures of the posterior pelvic ring is the percutaneous iliosacral screw technique.However,prolonged operation time and frequent fluoroscopies result in surgical risks.This study aimed to investigate whether a new triangulation method could reduce operative and fluoroscopy times and increase the accuracy of screw placement.Methods This study is a real-world retrospective cohort analysis that examined a patient cohort who underwent percutaneous iliosacral screw fixation between January 1,2019 and December 31,2022.Inclusion criteria were patients(1)diagnosed with posterior pelvic ring instability who underwent pelvic fracture closed reduction and percutaneous S1 transverse-penetrating iliosacral screw placement and(2)aged>18 years.Exclusion criteria were:(1)combined proximal femoral fractures,(2)severe soft tissue injury in the surgical area,(3)incomplete imaging data,and(4)declining to provide written informed consent by the patient.The patients were divided into 2 groups according to the screw insertion method:conventional and triangulation methods.Screw placement and fluoroscopy times recorded by the C-arm were compared between the 2 methods.The accuracy of screw placement was evaluated by Smith grading on postoperative CT.Normality tests were conducted to assess the distribution of the quantitative variables and the Chi-square test was used to compare the qualitative variables.Results The study included a total of 94 patients diagnosed with posterior pelvic ring instability,who underwent percutaneous iliosacral screw placement.The patients were divided into 2 groups:46 patients treated with the conventional surgical method and 48 patients received the triangulation method.The operation time(61.13±9.69 vs.35.77±6.27)min and fluoroscopy frequency times(52.15±9.29 vs.24.40±4.04)of the triangulation method were significantly reduced(p<0.001).Conclusions The use of a triangular positioning technique for the surface positioning of percutaneous iliosacral screws could reduce the operative time and fluoroscopy frequency.And the screw placement accuracy using this new method was comparable to that using other conventional methods.展开更多
文摘The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures of 3DPS were introduced.A retrospective analysis was performed on 49 patients with sacroiliac complex injury from March 2013 to May 2017.Twenty-one cases were treated by 3DPS,and 28 cases by MIRP.Intraoperative indexes as operative time,blood loss,incision length,length of hospital stay and postoperative complications were respectively documented.Quality of reduction was postoperatively evaluated by Matta radiological criteria,and clinical effect was assessed by Majeed scoring criteria at the last followup.Operative time and hospital stay were significantly shortened,and blood loss,and incision length were significantly reduced in 3DPS group as compared with those in MIRP group(P<0.05).No statistically significant difference was found between 3DPS group and MIRP group in the assessment of reduction and function(P>0.05).It was concluded that both 3DPS and MIRP can effectively treat the sacroiliac complex injury,and 3DPS can provide an accurate,safe and minimally invasive fixation with shorter operative time and hospital stay.
基金supported by the National Key Research and Development Program of China(2019YFF0302303).
文摘Purpose The fixation method commonly employed worldwide for treating unstable fractures of the posterior pelvic ring is the percutaneous iliosacral screw technique.However,prolonged operation time and frequent fluoroscopies result in surgical risks.This study aimed to investigate whether a new triangulation method could reduce operative and fluoroscopy times and increase the accuracy of screw placement.Methods This study is a real-world retrospective cohort analysis that examined a patient cohort who underwent percutaneous iliosacral screw fixation between January 1,2019 and December 31,2022.Inclusion criteria were patients(1)diagnosed with posterior pelvic ring instability who underwent pelvic fracture closed reduction and percutaneous S1 transverse-penetrating iliosacral screw placement and(2)aged>18 years.Exclusion criteria were:(1)combined proximal femoral fractures,(2)severe soft tissue injury in the surgical area,(3)incomplete imaging data,and(4)declining to provide written informed consent by the patient.The patients were divided into 2 groups according to the screw insertion method:conventional and triangulation methods.Screw placement and fluoroscopy times recorded by the C-arm were compared between the 2 methods.The accuracy of screw placement was evaluated by Smith grading on postoperative CT.Normality tests were conducted to assess the distribution of the quantitative variables and the Chi-square test was used to compare the qualitative variables.Results The study included a total of 94 patients diagnosed with posterior pelvic ring instability,who underwent percutaneous iliosacral screw placement.The patients were divided into 2 groups:46 patients treated with the conventional surgical method and 48 patients received the triangulation method.The operation time(61.13±9.69 vs.35.77±6.27)min and fluoroscopy frequency times(52.15±9.29 vs.24.40±4.04)of the triangulation method were significantly reduced(p<0.001).Conclusions The use of a triangular positioning technique for the surface positioning of percutaneous iliosacral screws could reduce the operative time and fluoroscopy frequency.And the screw placement accuracy using this new method was comparable to that using other conventional methods.
