• Der Unfallchirurg · Nov 2021

    [Triangular minimally invasive spinopelvic stabilization for type C pelvic fractures according to AO/OTA and type IV according to FFP].

    • Hans-Joachim Riesner, Hans-Georg Palm, Benedikt Friemert, Patricia Lang, and AG Becken, DGU®.
    • Klinik für Unfallchirurgie und Orthopädie, Rekonstruktive und septische Chirurgie, Sporttraumatologie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
    • Unfallchirurg. 2021 Nov 1; 124 (11): 923-930.

    IntroductionSpinopelvic instability is common in type IV fragility fractures of the pelvic ring (FFP) and type C traumatic pelvic fractures. This results in the indications for operative stabilization using a spinopelvic support. Due to the variety of surgical techniques for spinopelvic support it is unclear what importance a minimally invasive spinopelvic screw-rod osteosynthesis can have.Material And MethodsIn the retrospective clinical study over a period of 2 years, 23 patients (median age 67 years, 5 male and 18 female) with unstable pelvic fractures (FFP type IV: n = 12, AO/OTA type C: n = 11) treated by triangular minimally invasive spinopelvic stabilization (TMSS) were included in the study. The patient data were examined with respect to the parameters gender, age, fracture morphology, intraoperative blood loss, operating time, postoperative infection, postoperative reduction result in the computed tomography (CT) imaging and screw loosening.ResultsThe average age of the 11 type C fractures was 43 years and that of the 12 FFP type IV fractures was 80 years. The follow-up period was on average 12.2 months. The average operation time was 67 min, the blood loss was 70 ml, there were 2 postoperative infections and 4 cases of screw loosening. The reduction according to Matta was < 4 mm for all FFP and between 4-20 mm for traumatic pelvic fractures. Symptomatic pseudarthroses occurred in 3 cases.ConclusionThe triangular minimally invasive spinopelvic stabilization (TMSS) showed a stable and sufficient treatment of the type IV fragility fractures and in the slightly displaced type C traumatic pelvic fractures. Coarse fracture dislocations limit the procedure.© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

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