title: Treatment of pelvic fractures through a less invasive ilioinguinal approach combined with a minimally invasive posterior approach.
abstract: BACKGROUND
  Unstable pelvic fractures usually result from high-energy trauma. There are several treatment modalities available. The purpose of this study was to evaluate the clinical application of a new less invasive ilioinguinal approach combined with a minimally invasive posterior approach technique in patients with unstable pelvic fractures. We also address the feasibility, validity, and limitations of the technique.
  
  
  METHODS
  Thirty-seven patients with unstable pelvic fractures were treated with our minimally invasive technique. The anterior pelvic ring fractures were treated with a less invasive ilioinguinal approach, and the sacral fractures were treated with a minimally invasive posterior approach. The clinical outcome was measured using the Majeed scoring system, and the quality of fracture reduction was evaluated. The patients were followed up for 13 to 60 months (mean, 24 months).
  
  
  RESULTS
  Anatomical or near to anatomical reduction was achieved in 26 (70.3 %) of the anterior pelvic ring fractures and a satisfactory result was obtained in another 11(29.7 %). For the posterior sacral fractures, excellent reduction was obtained in 33 (89.2 %) of the fractures, with a residual deformity in the other 4 patients. One superficial wound infection and two deep vein thromboses occurred, all of which resolved with conservative treatment. The clinical outcome at one year was "excellent" in 29 patients and "good" in 8 patients (Majeed score).
  
  
  CONCLUSIONS
  The satisfactory results showed that a reduction and fixation of unstable pelvic fractures is possible through a combination of a limited ilioinguinal approach and posterior pelvic ring fixation. We believe our method is a new and effective alternative in the management of pelvic fractures.
authors.affiliation: Department of Orthopedic Trauma Surgery, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Rd., Huangpu District, Shanghai, China. hailangzhulei@126.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Orthopedic Surgery, Zhoushan Hospital, Zhejiang, China. gumawa@163.com.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Trauma Surgery, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Rd., Huangpu District, Shanghai, China. ben850616@hotmail.com.
authors.forename: Di
authors.initials: D
authors.lastname: Shen
authors.affiliation: Department of Orthopedic Trauma Surgery, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Rd., Huangpu District, Shanghai, China. yetianwen@hotmail.com.
authors.forename: Tian-wen
authors.initials: TW
authors.lastname: Ye
authors.affiliation: Department of Orthopedic Trauma Surgery, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Rd., Huangpu District, Shanghai, China. zhaoliangyu@sohu.com.
authors.forename: Liang-yu
authors.initials: LY
authors.lastname: Zhao
authors.affiliation: Department of Orthopedic Trauma Surgery, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Rd., Huangpu District, Shanghai, China. aiminchen@aliyun.com.
authors.forename: Ai-min
authors.initials: AM
authors.lastname: Chen
mesh_terms: D000328:Adult; D001863:Bone Screws; D005240:Feasibility Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult