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Complications after percutaneous internal fixator for anterior pelvic ring injuries


Fang, Christian; Alabdulrahman, Hatem; Pape, Hans-Christophe (2017). Complications after percutaneous internal fixator for anterior pelvic ring injuries. International orthopaedics, 41(9):1785-1790.

Abstract

OBJECTIVES: The aim of the study is to report on the observed incidence of complications following pedicle screw and rod internal fixator (INFIX) stabilization of pelvic ring fractures.
METHODS: In a retrospective review of consecutive patient series conducted in a University level 1 trauma hospital, 43 patients (21 female and eight male), mean age 64.2 (range 16-87) with OTA/AO type B or C pelvic ring fractures received percutaneous pedicle screw and rod internal fixator (INFIX) anterior stabilization of pelvic ring fractures; 29 fulfilled inclusion criteria with three months' minimal follow-up or known complication. Mean follow-up was 7.2 months. Main outcome measure was the incidence of complications and adverse outcomes.
RESULTS: Fourteen (48.3%) had injury to the lateral femoral cutaneous nerve (LFCN). Three (10.3%) had chronic pain of the pelvis not related to the LFCN. Five out of 29 (17%) of patients had unplanned removal before six weeks with two due to early loosening, one femoral nerve palsy, one deep infection and one painful implant impingement. There were no patients with deep vein thrombosis, no intra-abdominal violations or vascular complications; 22 (76%) returned to their premorbid walking status.
CONCLUSION: With high risk of LFCN injury, we caution against liberal use of the INFIX in patients with stable fractures where conservative treatment may be more appropriate. Most complications occurring from INFIX are self-limiting.

Abstract

OBJECTIVES: The aim of the study is to report on the observed incidence of complications following pedicle screw and rod internal fixator (INFIX) stabilization of pelvic ring fractures.
METHODS: In a retrospective review of consecutive patient series conducted in a University level 1 trauma hospital, 43 patients (21 female and eight male), mean age 64.2 (range 16-87) with OTA/AO type B or C pelvic ring fractures received percutaneous pedicle screw and rod internal fixator (INFIX) anterior stabilization of pelvic ring fractures; 29 fulfilled inclusion criteria with three months' minimal follow-up or known complication. Mean follow-up was 7.2 months. Main outcome measure was the incidence of complications and adverse outcomes.
RESULTS: Fourteen (48.3%) had injury to the lateral femoral cutaneous nerve (LFCN). Three (10.3%) had chronic pain of the pelvis not related to the LFCN. Five out of 29 (17%) of patients had unplanned removal before six weeks with two due to early loosening, one femoral nerve palsy, one deep infection and one painful implant impingement. There were no patients with deep vein thrombosis, no intra-abdominal violations or vascular complications; 22 (76%) returned to their premorbid walking status.
CONCLUSION: With high risk of LFCN injury, we caution against liberal use of the INFIX in patients with stable fractures where conservative treatment may be more appropriate. Most complications occurring from INFIX are self-limiting.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Trauma Surgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Complications; External fixator; Internal fixation; Lateral femoral cutaneous nerve; Minimal invasive surgery; Pelvis fracture
Language:English
Date:September 2017
Deposited On:14 Dec 2017 16:12
Last Modified:19 Feb 2018 09:35
Publisher:Springer
ISSN:0341-2695
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1007/s00264-017-3415-4
PubMed ID:28236073

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