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Plating of the Pelvis and Acetabulum via the Laparoscopic Technique: An Alternative Method for ORIF
Siyuan Qing1, Shaobo Zhang, Ruizhe Zhao
1From the Department of Orthopaedics (Dr. Qing), Nanjing Pukou Hospital of Traditional Chinese Medicine, Nanjing, China; the Department of urology (Dr. Zhang, Dr. Zhao, Dr. Li), the First Affiliated Hospital of Nanjing Medical University & Jiangsu Province Hospital, Nanjing, China; and the Department of Orthopaedics (Dr. Hong, Dr. Qin), the First Affiliated Hospital of Nanjing Medical University & Jiangsu Province Hospital, Nanjing, China.
Introduction:
Open reduction and internal fixation (ORIF) is a standard treatment for pelvic and acetabular fractures, but it is associated with great trauma and a high incidence of complications. The purpose of this retrospective study was to investigate whether laparoscopy can be used as an alternative to standard ORIF in the treatment of pelvic and acetabular fractures.
Materials And Methods:
This study included 15 patients with pelvic and acetabular fractures who underwent laparoscopy. The surgical time, intraoperative blood loss, and surgery-related complications of all the patients were recorded. The Matta score was used to evaluate the quality of fracture reduction after the surgery, and the modified Merle d'Aubigne & Postel score was used to evaluate hip joint function at the last follow-up.
Results:
The mean patient age was 50.8 ± 16.4 years, and the average surgical time was 224.4 ± 74.2 min. The intraoperative bleeding volume was 100.0 (50.0, 300.0) mL. The quality of fracture reduction was excellent in 10 patients and satisfactory in five patients. Hip function was excellent in seven patients and good in eight patients, with a score of 17.0 (17.0, 18.0). Intraoperative vascular injury occurred in two patients. Peritoneal rupture occurred in one patient. Partial loosening of the internal fixation was found in one patient at the last follow-up.
Conclusion:
Laparoscopic treatment of pelvic and acetabular fractures can achieve good clinical results, although there were 20% vascular and peritoneal complications and can be used as an alternative to ORIF in some cases.
