Three-dimensional guided percutaneous sacroiliac screw fixation combined with external fixator for the treatment of Tile type B/C pelvic fracture

MENG Cheng-fei; SONG Hu; WANG Xiao-zhen; WANG Guo-dong; LIU Xi-ming

doi:10.3969/j.issn.1009-4237.2018.01.002

Abstract：Objective To investigate the clinical efficacy of three-dimensional guided percutaneous sacroil-iac screw fixation combined with external fixator in the treatment of Tile B /C type pelvic fracture.Methods The data of 18 cases of Tile type B/C pelvic fracture who were admitted and treated in Wuhan General Hospital of PLA from Mar.2015 to May 2016 were analyzed retrospectively .There were 11 males and 7 females,with an average of 35.5 years(range,18-63 years).The Tile type B/C classification of pelvic fractures indicated type B 1 in 7 cases, B2 type in 5 cases,B3 type in 2 cases,C1 type in 3 cases,and C2 type in 1 case.The 18 cases of sacroiliac complex injuries were treated by three-dimensional guided percutaneous sacroiliac screw fixation , and the anterior ring was treated with a combined external fixator .Results All patients underwent surgical incisions with grade A healing . One patient developed external fixator loosening at the third day after operation ,and was re-performed the ring open reduction and plate screw fixation;1 patient was discharged from the hospital ,and was found external fixator loose-ning after one month ,and recovered well 3 months after re-tightening the external fixator .The quality of fracture re-duction was evaluated according to Matta radiological criteria and found excellent in 10 cases,good in 7 cases,fair in 1 case,with the excellent and good rate of 88.9％.At 3 months after the operation,the external fixator was re-moved.X-ray and CT three-dimensional reconstruction showed no separation of the symphysis pubis .The fracture healing was good ,and the sacroiliac joint screws were free of fracture ,loosening and prolapse in 17 patients.Except for one patient who changed internal fixation ,the other 17 patients were followed-up for 10-24 months,with an aver-age of 18.6(10-24) months.The pelvic function was evaluated according to the Majeed scoring criteria at the last follow-up and found excellent in 10 cases,good in 7 cases,with the excellent and good rate of 100％.Conclusion Three-dimensional guided percutaneous sacroiliac screw fixation combined with external fixator for the treatment of Tile B/C type pelvic fracture is safe ,effective and easy to be operated .