Posterior pelvic ring injuries: when to perform open reduction and internal fixation

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Skeletal Repair

Background:

• Unstable posterior pelvic ring injuries present significant clinical challenges.
• Percutaneous iliosacral screw fixation is a common minimally invasive approach.
• This technique, while efficient, is associated with complications and treatment failures.

Purpose of the Study:

• To compare the effectiveness of open versus minimally invasive techniques for pelvic ring fixation.
• To identify factors influencing the success of open pelvic ring fixation.
• To optimize reduction quality and fixation stability in treating pelvic injuries.

Main Methods:

• Review of existing literature on pelvic ring fixation techniques.
• Analysis of factors influencing open pelvic fixation success: timing, surgical approach, clamp positioning, and implant selection.
• Comparison of outcomes between percutaneous and open fixation methods.

Main Results:

• Open techniques provide enhanced reduction quality and fixation stability for unstable pelvic ring injuries.
• Minimally invasive percutaneous screw fixation, though efficient, carries risks of complications and failure.
• Optimal outcomes with open fixation depend critically on surgical timing, approach, clamp use, and implant choice.

Conclusions:

• Open surgical techniques are a viable alternative to percutaneous fixation for achieving superior stability in pelvic ring injuries.
• Careful consideration of surgical variables is crucial for successful open pelvic fixation.
• Further research may elucidate optimal strategies for managing complex pelvic ring fractures.