[Minimal invasive fixation for pelvic fracture with fluoroscopy-based navigation].
OBJECTIVE
To evaluate the security and effectiveness of minimal invasive fixation with fluoroscopy-based navigation in the management of pelvic fractures.


METHODS
From April 2007 to June 2008, 22 patients with pelvic fractures were treated with percutaneous screw fixation under the guidance of a fluoroscopy-based navigation system after closed reduction. There were 13 males and 9 females, aged 21-65 years old. Fractures were caused by traffic accident in 17 cases, and falling from height in 5 cases. According to AO classification, there were 2 cases of A2.2 type, 2 cases of A2.3 type, 7 cases of B1.2 type, 3 cases of B2.2 type, 1 case of B3.3 type, 2 cases of C1.2 type, 3 cases of C1.3 type, and 2 cases of C2.3 type. The interval from injury to hospitalization was 4 hours to 3 days (mean 1.2 days). After 3-13 days of skeletal traction through tibial tubercle, the operation was performed.


RESULTS
Totally 42 screws were inserted. The average time for operation was 20.4 minutes per screw. Forty-one screws were inserted correctly with a successful insertion rate of 97.6%, only 1 hollow screw was reinserted for deviation. No incision problem and implant failure occurred. All 22 patients were followed up 7 to 21 months with an average of 14.5 months. At last follow-up, fracture union was achieved in all patients with satisfactory screw fixation. According to Majeed functional scoring, the results were excellent in 18 cases and good in 4 cases, with an excellent and good rate of 100%.


CONCLUSIONS
The minimal invasive fixation with fluoroscopy-based navigation makes the surgery for the pelvic fracture more precise and time-saving, and improves clinical results without an increasing rate of complications.
Zeng
Zhimin
Z
Department of Orthopedics, Affiliated Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, PR China.
Luo
Congfeng
C
Hu
Chengfang
C
D000328:Adult; D000368:Aged; D005260:Female; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010384:Pelvic Bones / Q000293:injuries*; D025321:Surgery, Computer-Assisted; D055815:Young Adult