Therapeutic effects of minimally invasive adjustable and locking compression plate for unstable pelvic fractures via posterior approach

Tao Wu; Wei Chen; Qi Zhang; Xu Li; Hong-Zhi Lv; Guang Yang; Ying-Ze Zhang

Therapeutic effects of minimally invasive adjustable and locking compression plate for unstable pelvic fractures via posterior approach

Int J Clin Exp Med. 2015 Jan 15;8(1):827-35. eCollection 2015.

Authors

Tao Wu¹, Wei Chen¹, Qi Zhang¹, Xu Li¹, Hong-Zhi Lv¹, Guang Yang¹, Ying-Ze Zhang¹

Affiliation

¹ Emergency Center of Trauma, Key Laboratory of Orthopaedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Orthopaedic Research Institution of Hebei Province Shijiazhuang 050051, China.

PMID: 25785063
PMCID: PMC4358518

Abstract

Objective: Unstable pelvic fractures are clinically complex injuries. Selecting appropriate treatment remains a challenging problem for orthopedic physicians. The aim of this study is to compare the clinical effects of minimally invasive adjustable plate and locking compression plate in treatment of unstable pelvic fractures via posterior approach.

Methods: From January 2009 to June 2012, fifty-six patients with unstable pelvic fractures were included. After at least 12-month follow-up, forty-four patients treated with two methods were enrolled in the study and divided into two groups: minimally invasive adjustable plate (group A) and locking compression plate (group B). Preoperative and postoperative radiography was taken to assess the fracture displacement and reduction quality. The size of incision, operation duration, blood loss, duration of X-ray exposures, Majeed postoperative functional evaluation and Lindahl postoperative reduction evaluation were analyzed.

Results: The mean follow-up in group A was 27.3 months (range, 13-48 months), and that in group B was 21.8 months (range, 12-42 months). There were no iatrogenic neurovascular injuries during the operations in the two groups. In group B, malunion was observed in one patient, and infection of incision was observed in one case. The operation duration, blood loss, and size of incision of group A were significantly less than that of group B. There was no significant difference in the duration of X-ray exposures between the two groups. The Majeed functional evaluation score in group A was significantly higher than that in group B. The difference of the imaging score of the retained displacement was not statistically significant.

Conclusions: Both the two methods can effectively stabilize the unstable pelvic fractures. However, the minimally invasive adjustable plate has the advantages of minimally invasive, less radiation exposure, technically safe and time saving. Minimally invasive adjustable plate is a good supplementary option for treating posterior pelvic ring injuries.

Keywords: Unstable pelvic fractures; fracture fixation; internal; minimally invasive adjustable plate; minimally invasive reduction; posterior approach.