| Research background:It is widely accepted that posterior pelvic ring plays an essential role in achieving pelvic stability.Techniques of posterior pelvic ring fixation mainly consist of open reduction and internal fixation using plates,percutaneous screws fixation,spinopelvic fixation,et al.Recently,percutaneous screw fixation assisted by robot navigation are widely used.Scholars haven’t achieved a consensus on the best technique of posterior pelvic ring fixation so far.It is a challenge for surgeons to choose an appropriate technique to fix the poster pelvic ring.Objective:By comparing the intraoperative and postoperative indexes of different internal fixation techniques in treating unstable posterior pelvic injury,the advantages and disadvantages of various internal fixation techniques and their clinical efficacies were evaluated,so as to provide a strong reference for the treatment of unstable posterior pelvic injury.Materials and Methods:A retrospective analysis of 61 patients with type C pelvic fracture who underwent surgical treatment in department of orthopedics of China-Japan Union hospital of Jilin University from March 2018 to July2020 was conducted in this study.There were 20 cases were fixed with anterior plates of pelvic ring with an average age of 45.20±12.65.There were 20 cases of percutaneous screw fixation assisted by robot navigation with the average age of 42.80±14.92.There were 21 cases of spinopelvic fixation with an average age of 37.55±10.98.For statistical analysis,R was first used to analyze the homogeneity of variance of age,gender and ISS score among different groups.Secondly,R was used to make variance analysis for data of each group.Moreover,the results were analyzed and the differences in operation time,blood loss volume,incision length,healing time and Majeed score among the three groups were compared using LSD method in the Agricolae package.The significance level is 0.05 for all the tests.Results:For plate fixation group,the average operation time was 149.00±51.70 min.The average intra-operative blood loss volume was 835.00±445.18 m L.Average incision length 30.50±10.83 cm;The mean fracture healing time was 82.50±32.56 days.The average Majeed score was96.40±2.64.As for percutaneous screws fixation group,the average operative time of the screw group was 148.25±33.92 min.The average intra-operative blood loss was 69.50±21.14 m L.The average incision length was 5.30±1.34 cm.The mean fracture healing time was 92.00±25.87 days.The average Majeed score was 97.70±2.45.The incision length and intra-operative blood loss were significantly lower than those of the other two groups.The average operation time of the spinopelvic fixation group was 192.50±31.27 min.The average intra-operative blood loss was 730.00±165.75 m L.The average incision length was 22.70±2.75 cm.The average fracture healing time was 169.50±53.06 days.The average Majeed score is 96.15±2.06.Conclusion:Type C pelvic fractures have severe injuries that need surgeries in order to get better outcomes.The anterior plates of posterior ring,the percutaneous screws of robot navigation and lumbar iliac fixations have favorable effects on pelvic posterior ring injury.Fixation with percutaneous screws assisted by a robotic navigation and location system is safe and effective for the treatment of unstable posterior pelvic ring injuries,with shorter operation time and less bleeding,which provide a better outcome and allow earlier operations. |
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