title: Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation: initial clinical series.
abstract: OBJECTIVE
  To present a novel internal fixation device for stabilizing unstable pelvic fractures using supra-acetabular spinal pedicle screws and a subcutaneous connecting rod (INFIX).
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Twenty-four patients with rotational or vertically unstable pelvic fractures that reported to a level I trauma center. METHODS/INTERVENTION: Surgical treatment of unstable pelvic fractures included reduction, appropriate posterior fixation where indicated, and an anterior subcutaneous internal fixator.
  
  
  METHODS
  Healing time, quality and loss of reduction, ease of nursing, incidence of complications, including nonunion, infection, and patient mobility and comfort.
  
  
  RESULTS
  In the present clinical series, all fractures healed without significant loss of reduction. There were no infections, delayed unions or nonunions. Nursing care was observed to be easier especially in the intensive care unit setting. Complications included unilateral anterior thigh paresthesias in 2 patients, and 1 patient each required repositioning of the pedicle screw and readjustment of screw rod junction. Patients tolerated the procedure well and were fairly mobile after the procedure.
  
  
  CONCLUSIONS
  The reported technique allows for a definitive and stable anterior fixation of vertically and rotationally unstable pelvic fractures when combined with the appropriate posterior fixation if indicated. The potential complications are acceptable with this technique and good outcomes were achieved. A second operative procedure is required for removal of the device. It is our view that its best indication is in obese individuals, in whom other options have shortcomings.
authors: Department of Orthopedic Surgery, Detroit Receiving Hospital and University Health Center, Detroit, MI, USA.
authors: Rahul
authors: R
authors: Vaidya
authors: Robert
authors: R
authors: Colen
authors: Jonathan
authors: J
authors: Vigdorchik
authors: Fredrick
authors: F
authors: Tonnos
authors: Anil
authors: A
authors: Sethi
mesh_terms: D000328:Adult; D000368:Aged; D003758:Dental Implantation, Endosseous; D020878:Device Removal; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D009765:Obesity; D010384:Pelvic Bones / Q000293:injuries*; D011183:Postoperative Complications; D011474:Prosthesis Design; D055815:Young Adult