Treatment of Unstable Posterior Pelvic Ring Fracture with Pedicle Screw-Rod Fixator Versus Locking Compression Plate: A Comparative Study

采用椎弓根螺钉棒外固定器与锁定加压钢板治疗不稳定型后骨盆环骨折的比较研究

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Abstract

BACKGROUND The aim of this study was to assess the clinical results of treatment for unstable posterior pelvic fractures using a pedicle screw-rod fixator compared to use of a locking compression plate. MATERIAL AND METHODS A retrospective study was performed between June 2010 and May 2014 and the data were collected from 46 patients with unstable posterior pelvic ring fractures. All patients were treated using either a pedicle screw-rod fixator (study group, 24 patients) or locking compression plate (control group, 22 patients). In these patients, causes of injury included traffic accidents (n=27), fall from height (n=12), and crushing accidents (n=7). The quality of reduction and radiological grading were assessed. Clinical assessments included the operation time, times of X-ray exposures, bleeding volume during operation, incision length, and Majeed postoperative functional evaluation. RESULTS No iatrogenic neurovascular injuries occurred during the operations in these 2 groups. The average follow-up time was 24.5 months. All fractures were healed. The significant differences (P<0.05) between the 2 groups were operation duration, size of incision, and intraoperative bleeding volume. Statistically significant differences in the Majeed postoperative functional evaluation and times of X-ray exposures were not found between the 2 groups. CONCLUSIONS Similar clinical effects were achieved in treating the posterior pelvic ring fractures using the pedicle screw-rod fixator and the locking compression plate. However, the pedicle screw-rod fixator has the advantages of smaller incision, shorter duration of the operation, and less bleeding volume compared to using the locking compression plate.

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