Minimally invasive treatment of unstable pelvic ring injuries with modified pedicle screw–rod fixator

Abstract

Objective: To evaluate the clinical application of the minimally invasive modified pedicle screw–rod fixator for unstable pelvic ring injuries, including its feasibility, merits, and limitations. Methods: Twenty-three patients (13 males, 10 females; average age, 36.3 years) with unstable pelvic ring injuries underwent anterior fixation using a modified pedicle screw–rod fixator with or without posterior fixation using a transiliac internal fixator. The clinical findings were assessed using Majeed scores. The quality of reduction was evaluated using the Matta criteria. Results: Clinical results at 1 year postoperatively were excellent in 14 patients, good in 7, and fair in 2. The two patients with fair results had intermittent pain at the sacroiliac joint because of the posterior implant. One woman complained of persistent pain at the pubic tubercle during sexual intercourse. Iatrogenic neuropraxia of the unilateral lateral femoral cutaneous nerve occurred in three patients. Unilateral femoral nerve palsy occurred in one patient. The quality of fracture reduction was excellent in 12 patients, good in 8, and fair in 3. Heterotopic ossification occurred in eight patients; all were asymptomatic. Conclusions: Minimally invasive modified pedicle screw-rod fixation is an effective alternative treatment for pelvic ring injuries.