Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries
Introduction Identification of a proper fixation of the posterior pelvic ring is of paramount importance in treatment of patients with vertically unstable pelvic injuries. Material and methods Outcomes of 29 patients with polytrauma and vertically unstable pelvic injuries treated at Level I Trauma C...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2018-09-01
|
| Series: | Гений oртопедии |
| Subjects: | |
| Online Access: | http://ilizarov-journal.com/index.php/go/article/view/3449/3611 |
| _version_ | 1818304574797119488 |
|---|---|
| author | Alexander K. Dulaev Igor V. Kazhanov Vadim A. Manukovsky Artem V. Petrov Sergey I. Mikityuk |
| author_facet | Alexander K. Dulaev Igor V. Kazhanov Vadim A. Manukovsky Artem V. Petrov Sergey I. Mikityuk |
| author_sort | Alexander K. Dulaev |
| collection | DOAJ |
| description | Introduction Identification of a proper fixation of the posterior pelvic ring is of paramount importance in treatment of patients with vertically unstable pelvic injuries. Material and methods Outcomes of 29 patients with polytrauma and vertically unstable pelvic injuries treated at Level I Trauma Center between 2013 and 2017 were analyzed. The mean age of the patients was 34.8 ± 99 years. The severity of the injuries and patients’ condition were evaluated using Injury Severity Score (ISS), VPKh-P (MT), VPKh-SP, and Yu. N. Tsibin scales (1975) to determine the sequence of treatment and diagnostic procedures. Classification offered by Pape H. C. (2005) was used to evaluate physiological condition. The ISS score was 27.1 ± 9.9. All patients underwent
computed tomography (CT) scan of pelvic for preoperative planning. Lumbopelvic transpedicular fixation (LPTF) was employed as a definitive treatment of vertically unstable pelvic ring fractures in all clinical observations. Posterior half-ring morphology, a need for decompression of the nerve roots of the
sacral plexus, timing of surgery were considered to decide on LPTF configuration. Results Three-month-to-six-year follow-ups of 22 patients showed good and excellent results achieved in 72.7 % of the cases that are in line with findings reported in the literature. Discussion Biomechanically adequate method of internal fixation is the method of choice in the definitive treatment of vertical unstable pelvic injuries with the possibility of decompression of compromised neural structures. Lumbopelvic fixation with the possibility of simultaneous access for decompression of neural structures is the most optimal technique for these complicated injuries. |
| first_indexed | 2024-12-13T06:12:52Z |
| format | Article |
| id | doaj.art-12f45ebe5afe4f75a197cc6598c1cba2 |
| institution | Directory Open Access Journal |
| issn | 1028-4427 2542-131X |
| language | English |
| last_indexed | 2024-12-13T06:12:52Z |
| publishDate | 2018-09-01 |
| publisher | Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics |
| record_format | Article |
| series | Гений oртопедии |
| spelling | doaj.art-12f45ebe5afe4f75a197cc6598c1cba22022-12-21T23:57:02ZengRussian Ilizarov Scientific Center for Restorative Traumatology and OrthopaedicsГений oртопедии1028-44272542-131X2018-09-0124328228910.18019/1028-4427-2018-24-3-282-289Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuriesAlexander K. Dulaev0Igor V. Kazhanov1Vadim A. Manukovsky2Artem V. Petrov3Sergey I. Mikityuk4St. Petersburg Institute of Emergency Medicine named after I.I. Dzhanelidze, St. Petersburg, Russian FederationSt. Petersburg Institute of Emergency Medicine named after I.I. Dzhanelidze, St. Petersburg, Russian FederationSt. Petersburg Institute of Emergency Medicine named after I.I. Dzhanelidze, St. Petersburg, Russian FederationSt. Petersburg Institute of Emergency Medicine named after I.I. Dzhanelidze, St. Petersburg, Russian FederationSt. Petersburg Institute of Emergency Medicine named after I.I. Dzhanelidze, St. Petersburg, Russian FederationIntroduction Identification of a proper fixation of the posterior pelvic ring is of paramount importance in treatment of patients with vertically unstable pelvic injuries. Material and methods Outcomes of 29 patients with polytrauma and vertically unstable pelvic injuries treated at Level I Trauma Center between 2013 and 2017 were analyzed. The mean age of the patients was 34.8 ± 99 years. The severity of the injuries and patients’ condition were evaluated using Injury Severity Score (ISS), VPKh-P (MT), VPKh-SP, and Yu. N. Tsibin scales (1975) to determine the sequence of treatment and diagnostic procedures. Classification offered by Pape H. C. (2005) was used to evaluate physiological condition. The ISS score was 27.1 ± 9.9. All patients underwent computed tomography (CT) scan of pelvic for preoperative planning. Lumbopelvic transpedicular fixation (LPTF) was employed as a definitive treatment of vertically unstable pelvic ring fractures in all clinical observations. Posterior half-ring morphology, a need for decompression of the nerve roots of the sacral plexus, timing of surgery were considered to decide on LPTF configuration. Results Three-month-to-six-year follow-ups of 22 patients showed good and excellent results achieved in 72.7 % of the cases that are in line with findings reported in the literature. Discussion Biomechanically adequate method of internal fixation is the method of choice in the definitive treatment of vertical unstable pelvic injuries with the possibility of decompression of compromised neural structures. Lumbopelvic fixation with the possibility of simultaneous access for decompression of neural structures is the most optimal technique for these complicated injuries.http://ilizarov-journal.com/index.php/go/article/view/3449/3611unstable pelvic ring injurysacral fracturelumbosacral fixationminimally invasive osteosynthesis |
| spellingShingle | Alexander K. Dulaev Igor V. Kazhanov Vadim A. Manukovsky Artem V. Petrov Sergey I. Mikityuk Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries Гений oртопедии unstable pelvic ring injury sacral fracture lumbosacral fixation minimally invasive osteosynthesis |
| title | Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries |
| title_full | Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries |
| title_fullStr | Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries |
| title_full_unstemmed | Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries |
| title_short | Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries |
| title_sort | lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries |
| topic | unstable pelvic ring injury sacral fracture lumbosacral fixation minimally invasive osteosynthesis |
| url | http://ilizarov-journal.com/index.php/go/article/view/3449/3611 |
| work_keys_str_mv | AT alexanderkdulaev lumbopelvictranspedicularfixationofverticallyunstablepelvicringinjuries AT igorvkazhanov lumbopelvictranspedicularfixationofverticallyunstablepelvicringinjuries AT vadimamanukovsky lumbopelvictranspedicularfixationofverticallyunstablepelvicringinjuries AT artemvpetrov lumbopelvictranspedicularfixationofverticallyunstablepelvicringinjuries AT sergeyimikityuk lumbopelvictranspedicularfixationofverticallyunstablepelvicringinjuries |