Clinical Analysis Of Anterior And Posterior Ring Combined Fixation In The Treatment Of Tile B Type Pelvic Fracture

Objective: Tile B unstable pelvic fractures may involve partial injuries of the posterior pelvic ring sacroiliac joint complex,such as tearing of the anterior sacroiliac ligament,sacral wing fracture or sacroiliac joint fracture,etc.Inadequate stability of the pelvic ring may lead to many postoperative complications.For type B after pelvic fractures of sacroiliac ligament remains intact,maintain the vertical stability of pelvic posterior ring,for complex part involves the sacroiliac joint injury cases,clinical treatment is still controversial at home and abroad at present,treatment can only on the fixed ring before or after a fixed ring,or ring joint fixed before and after.The purpose of this study is to compare and analyze the efficacy of anterior fixation alone and combined anterior and posterior ring fixation in the treatment of Tile B type pelvic fracture with partial injury of sacroiliac joint complex,and to provide reference for the clinical treatment of patients with unstable pelvic fracture.Methods: A retrospective analysis was performed on 49 patients diagnosed with Tile B unstable pelvic fractures in our hospital from July 2016 to March 2021,including 28 males and21 females aged 18-69.All patients were divided into observation group and control group,among which 23 patients in the observation group were treated with anterior and posterior ring combined fixation,and 26 patients in the control group were treated with anterior ring fixation alone.By analyzing the general data of the patients,The time spent in operation,blood loss,postoperative fracture healing time,Majeed’s pelvic function score and VAS pain score were statistically analyzed,and the advantages and disadvantages of the two groups were obtained.Results:.The follow-up time of all patients was 12-15 months,with an average of 13.42 months.After statistical analysis,there were no significant differences in age,gender,injury causes and classification between the anterior and posterior ring combined fixation group and the anterior ring fixation group(P>0.05).There was no significant difference in the postoperative fracture healing period between the anterior and posterior ring combined fixation group and the anterior ring fixation group(P>0.05).There were significant differences in operative time and intraoperative blood loss between the anterior and posterior fixation group and the anterior and posterior fixation group(P<0.05).One week after surgery,the VAS pain score of the two groups was 3.30±1.22 points in the anterior and posterior ring combined fixation group and 5.96±1.18 points in the anterior ring alone fixation group.The difference between the two groups was statistically significant(P<0.05).Six months after surgery,the VAS pain score was 2.10±0.69 in the anterior-posterior loop combined fixation group and 4.49±0.66 in the anterior loop alone fixation group.The difference between the two groups was statistically significant(P<0.05).Twelve months after surgery,the VAS pain score was 1.17±0.30 points in the anterior and posterior ring combined fixation group,and 2.91±0.43 points in the anterior ring alone fixation group.The difference between the two groups was statistically significant(P<0.05).In pelvic Majeed scores 12 months after surgery,including pain scores,walking scores,sitting and standing scores,and working ability scores,the differences between the two groups were statistically significant(P<0.05).Conclusion: For patients with Tile B unstable pelvic fracture involving partial injury of the sacroiliac joint complex,patients with anterior and posterior ring combined with internal fixation have better postoperative results,with advantages of low pain,high pelvic function score and fewer postoperative complications,improving the quality of life of patients after surgery.