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Combination of Anterior and Posterior Subcutaneous Internal Fixation for Unstable Pelvic Ring Injuries: The "Hula Hoop Technique"

  • Received : 2018.03.16
  • Accepted : 2018.06.07
  • Published : 2019.03.31

Abstract

Unstable pelvic ring lesions are usually treated with internal fixation. In patients presenting clinical instability or soft tissue complication risk, external fixation is a safe treatment option. However, pin tract infection, insufficient biomechanical properties, difficulty sitting and changing decubitus are important drawbacks related to the treatment. The present study reports the association of anterior and posterior subcutaneous internal fixation by applying spine-designed implants on the pelvic ring disruption: supra-acetabular pedicle screws with an interconnecting rod (Infix), plus posterior transiliac fixation with the same system, which the authors have named the "Hula Hoop Technique".

Keywords

References

  1. Iorio JA, Jakoi AM, Rehman S. Percutaneous sacroiliac screw fixation of the posterior pelvic ring. Orthop Clin North Am 2015;46:511-21. https://doi.org/10.1016/j.ocl.2015.06.005
  2. Halawi MJ. Pelvic ring injuries: surgical management and longterm outcomes. J Clin Orthop Trauma 2016;7:1-6. https://doi.org/10.1016/j.jcot.2015.08.001
  3. Gardner, MJ, Mehta S, Mirza A, Ricci WM. Anterior pelvic reduction and fixation using a subcutaneous internal fixator. J Orthop Trauma 2012;26:314-21. https://doi.org/10.1097/BOT.0b013e318220bb22
  4. Routt ML, Simonian PT, Defalco AJ, Miller J, Clarke T. Internal fixation in pelvic fractures and primary repairs of associated genitourinary disruptions: a team approach. J Trauma 1996;40:784-90. https://doi.org/10.1097/00005373-199605000-00018
  5. Lerner A, Fodor L, Keren Y, Horesh Z, Soudry M. External fixation for temporary stabilization and wound management of an open pelvic ring injury with extensive soft tissue damage: case report and review of the literature. J Trauma 2008;65:715-8. https://doi.org/10.1097/01.ta.0000197416.63678.f6
  6. Bellabarba C, Ricci WM, Bolhofner BR. Distraction external fixation in lateral compression pelvic fractures. J Orthop Trauma 2000;14:475-82. https://doi.org/10.1097/00005131-200009000-00003
  7. Lindahl J, Hirvensalo E, Bostman O, Santavirta S. Failure of reduction with an external fixator in the management of injuries of the pelvic ring. Long-term evaluation of 110 patients. J Bone Joint Surg Br 1999;81:955-62. https://doi.org/10.1302/0301-620X.81B6.8571
  8. Tucker MC, Nork SE, Simonian PT, Routt ML Jr. Simple anterior pelvic external fixation. J Trauma 2000;49:989-94. https://doi.org/10.1097/00005373-200012000-00002
  9. Majeed SA. External fixation of the injured pelvis. The functional outcome. J Bone Joint Surg Br 1990;72:612-4. https://doi.org/10.1302/0301-620X.72B4.2380212
  10. Mears DC, Fu FH. Modern concepts of external skeletal fixation of the pelvis. Clin Orthop Relat Res 1980;(151):65-72.
  11. Wild JJ Jr, Hanson GW, Tullos HS. Unstable fractures of the pelvis treated by external fixation. J Bone Joint Surg Am 1982;64:1010-20. https://doi.org/10.2106/00004623-198264070-00007
  12. Riemer BL, Butterfield SL, Diamond DL, et al. Acute mortality associated with injuries to the pelvic ring: the role of early patient mobilization and external fixation. J Trauma 1993;35:671- 5; discussion 676-7. https://doi.org/10.1097/00005373-199311000-00003
  13. Vaidya R, Colen R, Vigdorchik J, Tonnos F, Sethi A. Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation: initial clinical series. J Orthop Trauma 2012;26:1-8. https://doi.org/10.1097/BOT.0b013e318233b8a7
  14. Dienstknecht T, Berner A, Lenich A, Nerlich M, Fuechtmeier B. A minimally invasive stabilizing system for dorsal pelvic ring injuries. Clin Orthop Relat Res 2011;469:3209-17. https://doi.org/10.1007/s11999-011-1922-y
  15. Fuchtmeier B, Maghsudi M, Neumann C, Hente R, Roll C, Nerlich M. The minimally invasive stabilization of the dorsal pelvic ring with the transiliacal internal fixator (TIFI)--surgical technique and first clinical findings. Unfallchirurg 2004;107:1142-51. https://doi.org/10.1007/s00113-004-0824-9
  16. Vaidya R, Oliphant B, Jain R, Nasr K, Siwiec R, Onwudiwe N, et al. The bikini area and bikini line as a location for anterior subcutaneous pelvic fixation: an anatomic and clinical investigation. Clin Anat 2013;26:392-9. https://doi.org/10.1002/ca.22149
  17. Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg Br 1989;71:304-6. https://doi.org/10.1302/0301-620X.71B2.2925751
  18. Wong JM, Bucknill A. Fractures of the pelvic ring. Injury 2013;13:556-61.
  19. Cole PA, Dyskin EA, Gilbertson JA. Minimally-invasive fixation for anterior pelvic ring disruptions. Injury 2015;46 Suppl 3:S27-34.
  20. Rudloff MI, Triantafillou KM. Management of pelvic ring injuries in unstable patients. Orthop Clin North Am 2016;47:551-63. https://doi.org/10.1016/j.ocl.2016.03.009
  21. Mason WT, Khan SN, James CL, Chesser TJ, Ward AJ. Complications of temporary and definitive external fixation of pelvic ring injuries. Injury 2005;36:599-604. https://doi.org/10.1016/j.injury.2004.11.016
  22. Vigdorchik JM, Esquivel AO, Jin X, Yang KH, Onwudiwe NA, Vaidya R. Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures. J Orthop Surg Res 2012;27:31.
  23. Chaus GW, Weaver MJ. Anterior subcutaneous internal fixation of the pelvis: placement of the INFIX. Operative technique in Orthopedics 2015;25:262-9. https://doi.org/10.1053/j.oto.2015.08.006
  24. Hesse D, Kandmir U, Solberg B, Stroh A, Osgood G, Sems SA, et al. Femoral nerve palsy after pelvic fracture treated with INFIX: a case series. J Orthop Trauma 2015;29:138-43. https://doi.org/10.1097/BOT.0000000000000193
  25. Vaidya R, Kubiak EN, Bergin PF, Dombroski DG, Critchlow RJ, Sethi A, et al. Complications of anterior subcutaneous internal fixation for unstable pelvis fractures: a multicenter study. Clin Orthop Relat Res 2012;470:2124-31. https://doi.org/10.1007/s11999-011-2233-z