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Comparison of posterior ring fixation with combined anterior and posterior ring fixation for the treatment of lateral compression type 2 pelvic fractures

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Abstract

Purpose

The aim of surgical treatment for lateral compression type 2 (LC-2) pelvic fractures is to enable early mobilization and provide pain relief. Anterior and posterior ring fixation is usually performed simultaneously, with the goal of providing good biomechanical stability. However, it is unclear whether anterior ring fixation is necessary. This study therefore aimed to determine the feasibility of isolated posterior ring fixation for LC-2 pelvic fractures.

Methods

Records of patients with LC-2 pelvic fractures were extracted from a medical database. Patients who underwent posterior pelvic ring fixation alone (PR fixation group) or anterior and posterior ring fixation (APR fixation group) were included. Patients’ operative characteristics, time to clinical healing, length of hospital stay, time to weight bearing, and complications were recorded at follow-up. Radiography was used to assess healing and fracture displacement. Functional outcomes were evaluated using the Majeed grading system.

Results

The PR fixation group included 44 patients, and the APR fixation group included 49 patients. Operative time, intra-operative blood loss, units of blood transfused, intra-operative fluid administered, and post-operative drainage were lower in the PR fixation group than in the APR fixation group. Length of hospital stay was also shorter in the PR fixation group than in the APR fixation group. Although the frequency (8/44) of fracture displacement in the superior ramus prior to union was high in the PR fixation group, no significant differences in time to weight bearing, time to clinical healing, or Majeed scores were found between the groups at follow-up.

Conclusions

Isolated posterior ring fixation for LC-2 pelvic fractures is feasible; patients who underwent treatment with this technique had functional outcomes similar to that of those who underwent anterior and posterior ring fixation.

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Funding

This work was supported by the Social Development Foundation of Shaanxi Province (grant no. 2017SF-050).

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Authors and Affiliations

  1. Department of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong University, No. 555 Youyi East Road, Beilin District, 710054, Xi’an, Shaanxi, People’s Republic of China

    Bin-Fei Zhang, Kun Shang, Peng-Fei Wang, Chao Ke, Shuang Han, Kun Yang, Chen Fei, Xin Xu, Kun Zhang & Yan Zhuang

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  1. Bin-Fei Zhang
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  2. Kun Shang
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  3. Peng-Fei Wang
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  4. Chao Ke
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  5. Shuang Han
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  6. Kun Yang
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  7. Chen Fei
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  8. Xin Xu
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  9. Kun Zhang
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  10. Yan Zhuang
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Correspondence to Yan Zhuang.

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The authors declare that they have no conflict of interest.

Ethical review committee statement

The study was approved by the Ethics Committee of the Xi’an Jiaotong University.

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Zhang, BF., Shang, K., Wang, PF. et al. Comparison of posterior ring fixation with combined anterior and posterior ring fixation for the treatment of lateral compression type 2 pelvic fractures. International Orthopaedics (SICOT) 44, 1187–1193 (2020). https://doi.org/10.1007/s00264-020-04512-1

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  • DOI: https://doi.org/10.1007/s00264-020-04512-1

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