title: The anterior subcutaneous internal fixator (ASIF) for unstable pelvic ring fractures: clinical and radiological mid-term results.
abstract: OBJECTIVE
  The purpose of this study was to determine the outcome of unstable type C pelvic fractures treated with posterior stabilisation and the anterior subcutaneous internal fixator (ASIF).
  
  
  METHODS
  Altogether, 36 consecutive patients were treated for unstable type C pelvic ring fractures using posterior stabilisation and ASIF. After a minimum of 18 months, the clinical and radiological outcome was retrospectively investigated.
  
  
  RESULTS
  Overall, three patients (8.3%) died, and 31 patients (86%) were available for follow-up after a mean of 4.5 years. Thirty of 31 patients (97%) showed radiographic bone consolidation of both the posterior and anterior pelvic ring. Only one non-union and two infections due to the anterior device were observed. The total German pelvic outcome score showed an excellent or good rating for 64.5% of the patients, and a fair or poor for 35.5%. The SF-12 questionnaire showed a significantly reduced total score for physical and mental health compared to a general reference population.
  
  
  CONCLUSIONS
  The ASIF represents an innovative surgical procedure for the treatment of type C pelvic ring fractures. In the medium term, patient satisfaction was high and the complication rate was low, despite the small number of patients. More cases must be investigated before the procedure can be recommended in general, possibly replacing the external fixator for the treatment of pelvic ring fractures in the future.
authors.affiliation: Clinic of Orthopaedic and Trauma Surgery, Hospital Barmherzige Brüder Regensburg, 93049, Regensburg, Germany, franz.mueller@barmherzige-regensburg.de.
authors.forename: Franz Josef
authors.initials: FJ
authors.lastname: Müller
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stosiek
authors.forename: Michael
authors.initials: M
authors.lastname: Zellner
authors.forename: Rainer
authors.initials: R
authors.lastname: Neugebauer
authors.forename: Bernd
authors.initials: B
authors.lastname: Füchtmeier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D050723:Fractures, Bone / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006304:Health Status; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult