The Clinical Effect Analysis Of Percutaneous Iliosacral Screws Osteosynthesis For Unstable Pelvic Fractures

Objective To compare the clinic outcomes of percutaneous iliosacral screws osteosynthesis and open reduction and internal fixation in treatment of unstable pelvic fractures; To evaluate the safety and practical applicability of percutaneous iliosacral screws osteosynthesis in treatment of unstable pelvic fractures.Method From May 2005 to October 2010,39 cases with unstable pelvis fractures were followed up.19 cases were treated with percutaneous iliosacral screws osteosynthesis under intraoperative monitoring with"C"arm fluoroscopic guidance and spontaneous electromyogram;20 cases were treated with open reduction and internal fixation,The data of two groups were collected for statistical analysis on the following aspects: preoperative parameter,Matta scores and Majeed function scores.Result Interaoperative, electromyogram appeared normal. Postoperatively, computerized tomography, all iliosacral screws were in good position, and there were no cases with iatrogenic nerve- root injury. All patients were normal neurologically. All patients were followed up for 24 months (ranged 6-48 months). There were statistically significant differences in the consumed time of operation, bleeding of operation, length of incision, pain of post - operation and the time after suture removal between the two groups(P<0.05) .There were no significant differences in Matta scores and Majeed function scores between the two groups (P > 0.05).Conclusion As long as indication well-directed and reasonable selection of internal fixation, rational operation,both the perctuaneous sacroilial screws osteosynthesis and open reduction and internal fixation are effective methods for the unstable pelvic fracture that can obtain the same good clinical effects. Perctuaneous sacroilial screw osteosynthesis has superiority of minimal trauma, less bleeding and light pain, if intraoperative use appropriate detection means, percutaneous sacroiliac screws technology is safe and feasible. It is a good incisive operation method and more in line with the development trend of minimally invasive surgery.