• Qian Wang, Qiugen Wang, and Jiandong Wang.
• Department of Trauma Orthopaedics, Shanghai First People's Hospital, Shanghai Jiaotong Unversity, No. 650, Xinsongjiang Rd, Songjiang District, 201620, Shanghai, China.
• Arch Orthop Trauma Surg. 2017 Jul 1; 137 (7): 887-893.

IntroductionTo evaluate the clinical outcomes of anterior subcutaneous internal fixator using triple pedicle screws (ASIF/TPS) in the treatment of unstable type B pelvic fracture compared with open reduction internal fixation (ORIF).Materials And MethodsThis was a retrospective cohort study of 26 patients with type B unstable fractures that underwent ASIF/TPS and 26 similar patients that underwent ORIF using plates and screws. Intraoperative blood loss, operating time, and post operation hospitalization duration were compared. Anteroposterior, inlet, and outlet X-rays and 3D computed tomography were obtained. Pain, numbness, sexual dysfunction, and activity were evaluated at every follow-up visit until the implants were removed. The Majeed score was used to assess the clinical and radiological outcomes.ResultsBlood loss, operating time, and hospitalization duration were less (all P < 0.001) in the ASIF/TPS group compared with the ORIF group. The clinical and radiological outcomes of the ASIF/TPS group after a mean follow-up of 6 months were excellent and good in 80.8%, and moderate in 19.2%. In comparison, the results of the ORIF group were excellent and good in 65.4%, moderate in 29.0%, and poor in 5.6%. No patient experienced nonunion, delayed union, superficial infection, or deep surgical wound infection. No urethral injury or dysuria occurred in the ASIF/TPS group. Two patients had temporary lateral femoral cutaneous nerve numbness after operation. There were two superficial wound infections in the ORIF group.ConclusionsThe use of ASIF/TPS with triple pedicle screws could be a reasonable option for the treatment of type B unstable pelvic fractures.

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