Objective To introduce the experience of intelligent monitoring system assisted pelvic fracture closed reduction to treat complex pelvic fracture in a minimally invasive method.Methods A 30-year-old male patient with complex pelvic fracture caused by a falling injury was treated in December 2019. The pelvic fracture was diagnosed by X-ray film and CT three-dimensional reconstruction. The AO/Orthopaedic Trauma Association (AO/OTA) classification was 61-C3.3 type (H-shaped sacrum fracture with pubic symphysis separation). At 48 hours after injury, the vital signs were stable, and the operation was performed. The pelvic fracture was reduced with the help of pelvic reduction frame and skeletal traction, the intelligent monitoring system, and fixed with the channel screws.Results The intraoperative blood loss was 50 mL, the operation time was 180 minutes, and the fluoroscopy time was 45 seconds. The incision healed well after operation. The X-ray film of pelvis was taken on the next day after operation, and the fracture reduction was evaluated as anatomical reduction according to Matta standard; CT three-dimensional reconstruction showed that the fixation screws were all located in the cortex of bone, without penetrating the cortex of bone.Conclusion The intelligent monitoring system assisted pelvic fracture closed reduction is reliable in the minimally invasive treatment of complex pelvic fractures, which can achieve good results and reduce intraoperative fluoroscopy.
Citation：
CHEN Hua, JIANG Bin, ZHANG Qun, CHANG Zuhao, YANG Zifeng, ZHANG Jian, LIU Haoyang, TANG Peifu. Intelligent monitoring system assisted pelvic fracture closed reduction for treating one case with complex pelvic fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(7): 874-877. doi: 10.7507/1002-1892.202001035
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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Lindsay A, Tornetta P 3rd, Diwan A, et al. Is closed reduction and percutaneous fixation of unstable posterior ring injuries as accurate as open reduction and internal fixation? J Orthop Trauma, 2016, 30(1): 29-33.
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Thaunat M, Laude F, Paillard P, et al. Transcondylar traction as a closed reduction technique in vertically unstable pelvic ring disruption. Int Orthop, 2008, 32(1): 7-12.
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Lefaivre KA, Starr AJ, Barker BP, et al. Early experience with reduction of displaced disruption of the pelvic ring using a pelvic reduction frame. J Bone Joint Surg (Br), 2009, 91(9): 1201-1207.
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Liu HS, Duan SJ, Liu SD, et al. Robot-assisted percutaneous screw placement combined with pelvic internal fixator for minimally invasive treatment of unstable pelvic ring fractures. Int J Med Robot, 2018, 14(5): e1927.
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Ghisla S, Napoli F, Lehoczky G, et al. Posterior pelvic ring fractures: Intraoperative 3D-CT guided navigation for accurate positioning of sacro-iliac screws. Orthop Traumatol Surg Res, 2018, 104(7): 1063-1067.
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陈华, 齐红哲, 朱正国, 等. 骨盆外架辅助复位联合通道螺钉固定治疗 Tile C1 型骨盆骨折. 中华创伤杂志, 2018, 34(10): 919-924.
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陈华, 齐红哲, 王彬彬, 等. 机器人体外通道螺钉定位系统联合骨盆随意外架辅助复位微创治疗复杂骨盆骨折一例. 中国修复重建外科杂志, 2016, 30(7): 915-917.
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Matta JM, Tornetta P 3rd. Internal fixation of unstable pelvic ring injuries. Clin Orthop Relat Res, 1996, (329): 129-140.
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Routt MLC Jr, Gary JL, Kellam JF, et al. Improved intraoperative fluoroscopy for pelvic and acetabular surgery. J Orthop Trauma, 2019, 33(Suppl 2): S37-S42.
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| 10. |
Gras F, Marintschev I, Wilharm A, et al. 2D-fluoroscopic navigated percutaneous screw fixation of pelvic ring injuries—a case series. BMC Musculoskelet Disord, 2010, 11: 153.
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- 1. Lindsay A, Tornetta P 3rd, Diwan A, et al. Is closed reduction and percutaneous fixation of unstable posterior ring injuries as accurate as open reduction and internal fixation? J Orthop Trauma, 2016, 30(1): 29-33.
- 2. Thaunat M, Laude F, Paillard P, et al. Transcondylar traction as a closed reduction technique in vertically unstable pelvic ring disruption. Int Orthop, 2008, 32(1): 7-12.
- 3. Lefaivre KA, Starr AJ, Barker BP, et al. Early experience with reduction of displaced disruption of the pelvic ring using a pelvic reduction frame. J Bone Joint Surg (Br), 2009, 91(9): 1201-1207.
- 4. Liu HS, Duan SJ, Liu SD, et al. Robot-assisted percutaneous screw placement combined with pelvic internal fixator for minimally invasive treatment of unstable pelvic ring fractures. Int J Med Robot, 2018, 14(5): e1927.
- 5. Ghisla S, Napoli F, Lehoczky G, et al. Posterior pelvic ring fractures: Intraoperative 3D-CT guided navigation for accurate positioning of sacro-iliac screws. Orthop Traumatol Surg Res, 2018, 104(7): 1063-1067.
- 6. 陈华, 齐红哲, 朱正国, 等. 骨盆外架辅助复位联合通道螺钉固定治疗 Tile C1 型骨盆骨折. 中华创伤杂志, 2018, 34(10): 919-924.
- 7. 陈华, 齐红哲, 王彬彬, 等. 机器人体外通道螺钉定位系统联合骨盆随意外架辅助复位微创治疗复杂骨盆骨折一例. 中国修复重建外科杂志, 2016, 30(7): 915-917.
- 8. Matta JM, Tornetta P 3rd. Internal fixation of unstable pelvic ring injuries. Clin Orthop Relat Res, 1996, (329): 129-140.
- 9. Routt MLC Jr, Gary JL, Kellam JF, et al. Improved intraoperative fluoroscopy for pelvic and acetabular surgery. J Orthop Trauma, 2019, 33(Suppl 2): S37-S42.
- 10. Gras F, Marintschev I, Wilharm A, et al. 2D-fluoroscopic navigated percutaneous screw fixation of pelvic ring injuries—a case series. BMC Musculoskelet Disord, 2010, 11: 153.
