The Clinical Study Of Open Reduction And Internal Fixation With Reconstruction Plate For Tile C Fracture

Objective:to explore the clinical efficacy of open reduction and internal fixation with reconstruction plate for Tile C fractureMethod:48cases of pelvic fracture from09/2009to03/2012were selected as subjects, including28male and20female;their ages spanned from19to61, with an average of41.5. Pelvic fracture in23patients were aroused by falling from high place,17by car accident,4by pressure and4by other factors. All patients were examined by X ray and identified as Tile C pelvic fracture during operation (type C1, C2, C3were25,11and12cases respectively). Some patients had multiple other injuries, including2cases of traumatic brain injury,6cases of pulmonary contusion,7cases of abdominal viscera closed injury,6cases of perineal injury,5cases of urethra and bladder injury,22cases of other fractures,6cases of sacral nerve injury.19cases were complicated with shock; their vital signs were stabilized after given aggressive fluid resuscitation and anti-shock treatment.9cases were also given emergency external fixation. Patients with serious injuries in other systems were first treated by the appropriate specialist and transferred to us after the condition was stabilized. All patients received reconstruction plate-open reduction-internal fixation treatment in5-18days after accompanied injuries got under control and the condition got stabilized.Results:No surgery-related deaths occurred. Incisions of46cases were fine,2cases were infected but cured after dressing change.3cases had pulmonary infection after surgery,5cases had urinary infections and1case had deep venous thrombosis; all recovered after consulting appropriate department. All cases were followed-up for12-30months. According to the Matta standard,31cases recovered excellently (maximum fracture displacement<4mm),10were good (maximum fracture displacement4-10mm) and7cases were acceptable (maximum fracture displacement10-20mm); the rate of excellent or good was85.42%(table2). The Majeed functional evaluation system covers pain, working conditions, standing, sex life and other aspects of recovery, the evaluation is marked by the hundred-mark system. And according to the Majeed standard,29cases were excellent,13good and6acceptable; rate of excellent or good was87.5%.Conclusion:our clinical study showed that the efficacy of open reduction and internal fixation with reconstruction plate for severe pelvic fracture was solid, greatly benefiting anatomical reduction, postoperative functional recovery and lowering rate of disability. This technique avoided damage to the articular surface, firmly fixed and reconstructed pelvic physiology structure, largely reducing pelvic malunion and other serious concurrent disease due to poor reduction or instable fixation in severe unstable pelvic fracture, thereby improving the quality of life after surgery. Provided reasonable timing of surgery and proper choice of indication, this technique would always achieve good clinical efficacy, and is an ideal technique for the treatment of Tile C pelvic fractures.