title: Complications after percutaneous internal fixator for anterior pelvic ring injuries.
abstract: The aim of the study is to report on the observed incidence of complications following pedicle screw and rod internal fixator (INFIX) stabilization of pelvic ring fractures.
  
  
  
  In a retrospective review of consecutive patient series conducted in a University level 1 trauma hospital, 43 patients (21 female and eight male), mean age 64.2 (range 16-87) with OTA/AO type B or C pelvic ring fractures received percutaneous pedicle screw and rod internal fixator (INFIX) anterior stabilization of pelvic ring fractures; 29 fulfilled inclusion criteria with three months' minimal follow-up or known complication. Mean follow-up was 7.2 months. Main outcome measure was the incidence of complications and adverse outcomes.
  
  
  
  Fourteen (48.3%) had injury to the lateral femoral cutaneous nerve (LFCN). Three (10.3%) had chronic pain of the pelvis not related to the LFCN. Five out of 29 (17%) of patients had unplanned removal before six weeks with two due to early loosening, one femoral nerve palsy, one deep infection and one painful implant impingement. There were no patients with deep vein thrombosis, no intra-abdominal violations or vascular complications; 22 (76%) returned to their premorbid walking status.
  
  
  
  With high risk of LFCN injury, we caution against liberal use of the INFIX in patients with stable fractures where conservative treatment may be more appropriate. Most complications occurring from INFIX are self-limiting.
authors.affiliation: Department of Orthopaedics and traumatology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China. fangcx@gmail.com.
authors.forename: Christian
authors.identifier: 0000-0002-3827-0351
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Orthopaedic Trauma, RWTH University of Aachen, 30 Pauwels street, 52074, Aachen, Germany.
authors.forename: Hatem
authors.initials: H
authors.lastname: Alabdulrahman
authors.affiliation: Department of Trauma, University Hospital Zurich, Raemistr. 100, 8091, Zurich, Switzerland.
authors.forename: Hans-Christophe
authors.initials: HC
authors.lastname: Pape
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D015994:Incidence; D016268:Internal Fixators / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult
keywords: Complications; External fixator; Internal fixation; Lateral femoral cutaneous nerve; Minimal invasive surgery; Pelvis fracture