Document Detail


Complications of anterior subcutaneous internal fixation for unstable pelvis fractures: a multicenter study.
MedLine Citation:
PMID:  22219004     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Stabilization after a pelvic fracture can be accomplished with an anterior external fixator. These devices are uncomfortable for patients and are at risk for infection and loosening, especially in obese patients. As an alternative, we recently developed an anterior subcutaneous pelvic internal fixation technique (ASPIF).
QUESTIONS/PURPOSES: We asked if the ASPIF (1) allows for definitive anterior pelvic stabilization of unstable pelvic injuries; (2) is well tolerated by patients for mobility and comfort; and (3) has an acceptable complication rate.
METHODS: We retrospectively reviewed 91 patients who incurred an unstable pelvic injury treated with an anterior internal fixator and posterior fixation at four Level I trauma centers. We assessed (1) healing by callous formation on radiographs and the ability to weightbear comfortably; (2) patient function by their ability to sit, stand, lie on their sides, and how well they tolerated the implants; and (3) complications during the observation period. The minimum followup was 6 months (mean, 15 months; range, 6-40 months).
RESULTS: All 91 patients were able to sit, stand, and lie on their sides. Injuries healed without loss of reduction in 89 of 91 patients. Complications included six early revisions resulting from technical error and three infections. Irritation of the lateral femoral cutaneous nerve was reported in 27 of 91 patients and resolved in all but one. Heterotopic ossification around the implants, which was asymptomatic in all cases, occurred in 32 of 91 patients.
CONCLUSIONS: The anterior internal fixator provided high rates of union for the anterior injury in unstable pelvic fractures. Patients were able to sit, stand and ambulate without difficulty. Infections and aseptic loosening were reduced but heterotopic ossification and irritation of the LFCN are common.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors:
Rahul Vaidya; Erik N Kubiak; Patrick F Bergin; Derek G Dombroski; Ren J Critchlow; Anil Sethi; Adam J Starr
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-10     Completed Date:  2012-09-20     Revised Date:  2013-08-15    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2124-31     Citation Subset:  AIM; IM    
Affiliation:
Detroit Medical Center, Wayne State University, 4D-4 University Health Center, Detroit Receiving Hospital, Detroit, MI 48201, USA. rvaidya@dmc.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Bone Malalignment / radiography,  rehabilitation,  surgery*
Female
Fracture Fixation, Internal / adverse effects*
Fracture Healing
Fractures, Compression / radiography,  rehabilitation,  surgery*
Hip Fractures / surgery*
Humans
Male
Middle Aged
Ossification, Heterotopic / etiology
Pelvic Bones / injuries*,  radiography
Postoperative Complications*
Prosthesis Failure
Radiculopathy / etiology
Reoperation
Retrospective Studies
Surgical Procedures, Minimally Invasive / adverse effects,  methods*
Surgical Wound Infection / etiology
Young Adult
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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