Minimal Invasive Fixation of Pelvic Fractures Using the In-Fix Technique - Preliminary Results from the Soroka University Medical Center
Objectives: To present preliminary results with the use of the INFIX technique for minimally invasive fixation of unstable pelvic fractures.
Patients: A total of seven patients with rotational or vertically unstable pelvic fractures that reported to a level I trauma center between October 2013 and April 2105.
Methods/intervention: Surgical treatment of unstable pelvic fractures was planned according to the injury. All patients had a closed reduction. 3 patients were treated using SI screws and an anterior INFIX, 2 patients were treated with a posterior INFIX as the sole fixation and 2 other patients were treated using posterior and anterior INFIX.
Main Outcome Measurement: 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 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 lateral cutaneous femoral nerve irritation in 1 patient and he is due for removal of the INFIX. 1 patient had an elective removal of the INFIX due to planned pregnancy. All patients who were treated using the anterior INFIX developed painless Heterotopic ossification around the screw heads per x-ray. Patients tolerated the procedure well and were fairly mobile after the procedure.
Conclusions: The reported technique allows for a definitive and stable fixation of vertically and rotationally unstable pelvic fractures, using a minimally invasive safe approach. The main benefit of this method over regular External Fixator is the that we can achieve great pelvic stability without the complications of the External device, mainly infections and ease of nursing treatment. We believe that a second operative procedure is required for removal of the device even in asymptomatic patients.