Minimally invasive treatment for anterior pelvic ring injuries with modified pedicle screw-rod fixation: A retrospective study

Background: Pelvic ring injuries constitute only 2 to 8% of all fractures; however, they occur in 20% of polytrauma patients. High-energy pelvic fractures often result in mechanical instability of the pelvic ring. Successful treatment of unstable pelvic ring fractures remains a challenge for orthopedic surgeons. This study presents a novel internal fixation method for stabilizing unstable anterior pelvic ring fractures using a minimally invasive modified pedicle screw-rod fixation (MPSRF) technique. Methods: This retrospective study included six patients with unstable pelvic ring injuries who underwent MPSRF, with or without posterior fixation. Intraoperative parameters such as blood loss, operative time, complications, and quality of reduction (Matta criteria) were recorded and evaluated by a blinded reviewer. Results: In the present clinical series, the mean operative times and mean blood loss for unilateral versus bilateral anterior ring fixations were 176.0min versus 295.6min, and 153.3mL versus 550.0mL, respectively. No iatrogenic neuropraxia of the lateral femoral cutaneous nerve or femoral nerve palsy occurred. The reduction quality, graded by the Matta criteria, was excellent in five patients and good in one patient. Conclusions: There were no infections, delayed unions, nonunions, or loss of reductions during the follow-up period. Only one patient suffered from a broken rod at 4months postoperatively. The modified technique represents a novel, minimally invasive procedure for the treatment of anterior pelvic ring fractures and offers a reliable and effective alternative to currently available surgical techniques.