A minimally invasive stabilizing system for dorsal pelvic ring injuries

Area of Science:

• Orthopedic surgery
• Trauma surgery
• Minimally invasive procedures

Background:

• Open reduction and stabilization of dorsal pelvic ring injuries often lead to soft tissue complications.
• Minimally invasive techniques may reduce soft tissue trauma but carry risks of iatrogenic nerve and vessel damage.
• The transiliac internal fixator (TIFI) was employed as a minimally invasive approach for these injuries.

Purpose of the Study:

• To evaluate the efficacy of the transiliac internal fixator (TIFI) in achieving anatomic restoration for dorsal pelvic ring injuries.
• To assess specific complications associated with this minimally invasive approach, including blood loss and neurovascular damage.
• To compare functional outcomes at 3 years post-trauma with established fixation methods.

Main Methods:

• Retrospective review of 67 patients with dorsal pelvic injuries treated over 7 years.
• Radiographic evaluation of fracture displacement and assessment of complications.
• Functional outcome assessment using the Pelvic Outcome Score at a minimum of 3 years post-trauma.

Main Results:

• Excellent or good anatomic reduction was achieved in most patients, with minimal secondary displacement.
• Intraoperative blood loss was consistently low (<50 mL), and no iatrogenic neurovascular lesions occurred.
• Complications included wound infections (4 patients), screw loosening (1 patient), and screw malpositioning (1 patient).
• Functional outcomes were favorable, with 35 of 62 patients achieving high Pelvic Outcome Scores.

Conclusions:

• The transiliac internal fixator (TIFI) is a viable alternative for dorsal pelvic ring injuries.
• This minimally invasive technique demonstrates a low risk of significant blood loss and iatrogenic neurovascular damage.
• TIFI facilitates good functional outcomes in patients with dorsal pelvic ring injuries.