Anterior minimal invasive internal fixator versus open plating in treatment of unstable pelvic ring injuries

Pelvic fractures are frequently presented to major trauma centers and are mostly associated with high morbidity, especially in polytrauma patients. While stable fractures are managed non-operatively in most cases, unstable patterns necessitate surgical fixation because of the significant morbidity and mortality related to unstable pelvic fractures.

To compare the clinical, radiological, and functional outcomes in patients with unstable pelvic ring fractures treated with anterior minimal invasive internal fixator (INFIX) versus plate fixation.

Retrospective single-center clinical study.

This research was conducted on 60 patients with unstable pelvic ring injuries. There were 38 (63.3%) males and 22 (36.7%) females with a mean age of 33.57 ± 11.03 years. Half of the patients were managed with INFIX, and the other half with open plating. Pelvic deformity index (PDI) and symphyseal widening were used to assess the pelvic ring reductions.

Reduction of symphyseal widening was significantly better in open plating than in the INFIX group (P < 0.001), but both techniques are comparable in reducing PDI. Time to surgery, whole operative time, anterior pelvic ring procedure time, hospital stay, and blood loss decreased significantly in the INFIX group compared to the plate group (P < 0.001).

INFIX is a minimally invasive procedure that provides much lower operative time and less blood loss than open plating in the anterior pelvic ring fracture management. Meanwhile, more anatomical reduction of the anterior pelvic ring fracture was achieved through plate fixation. There was a significant difference in the postoperative symphyseal diastasis achieved with plating compared to INFIX [plating (5.47 ± 2.03 mm) lower than INFIX(11.40 ± 3.76 mm)].