External fixator with lumbopelvic distraction spondylodesis for vertically unstable pelvic fracture

胡昊 (Hu Hao，Dept Orthop，Zhongnan Hosp，Wuhan Univ，Wuhan 430071)… ∥Chin J Orthop.－ 2011，31(1).－61～65

External fixator with lumbopelvic distraction spondylodesis for vertically unstable pelvic fracture

胡昊 (Hu Hao，Dept Orthop，Zhongnan Hosp，Wuhan Univ，Wuhan 430071)… ∥Chin J Orthop.－ 2011，31(1).－61～65

ObjectiveTo evaluate the clinical outcomes of external fixator with lumbopelvic distraction spondylodesis in treatment of vertically unstable pelvic fractures.MethodsFrom January 2008 to March 2009，9 patients(4 males and 5 females)with a vertically unstable pelvic fracture were treated with modular external fixator with lumbopelvic distraction spondylodesis.According to the classification of Tile，9 fractures were classified as type C.This fixation construct comprises a vertical lumbopelvic distraction component which fixed L4，5and the posterior superior iliac spine and a transverse fixation which fixed anterior iliac spine with external fixator.ResultsAll patients were followed up 12－18 months after surgery，with an average of 14.3 months.Postoperative X-ray showed satisfactory reduction of pelvic fracture.Pelvic fractures healed in all patients without loss of reduction 3 －6 months after operation.According to Matta reduction evaluation criteria，6 patients were excellent and 3 good.For the two patients with sacral neurological injuries，appropriate surgical decompression was performed to improve the symptom and minimize the deformity.No iatrogenic complications of neurovascular injury occurred.Patients now walk unassistedly without pain in the waist or legs，and with no shortening of lower limbs or claudication.By considering symptom and satisfactory scores，the Majeed functional assessment revealed that seven patients had excellent results and two good at one year.ConclusionExternal fixator with lumbopelvic distraction spondylodesis that allowed early mobilization and ambulation，with general applicability and definite safety，is an effective surgical technique for the treatment of vertically unstable pelvic fracture.24 refs，1 fig.

(Authors)