Authors (including presenting author) :
Lau JCK(1), Chan L(2), Chang A(2), Chui KH(1), Lee KB(1), Li Wilson(1)
Affiliation :
(1)Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, (2)Central Nursing Division, Queen Elizabeth Hospital
Introduction :
Over the past decade, there is an almost three-fold increase in number of trauma patients with orthopedic problems, among which the complex pelvi-acetabular fracture remains a substantial burden. In spite of the growing patient number within this period, the survival rate improved from 27% to 82% with enhanced standardised acute management. This brought further tension to the load in definitive fracture fixation in these patients. In view of such, Queen Elizabeth Hospital developed the 3D-Navigation Guided Minimally Invasive Percutaneous Screw Fixation (MIS) technique for patients with pelvic-acetabular fractures. It has been shown to be a shorter surgery with less stress to the severely injured patients in previous studies.
Objectives :
To evaluate the short-term results and efficiency of MIS technique in pelvic-acetabular fixation.
Methodology :
A retrospective study is conducted in a single trauma center. All patients in the recent ten years with (1) high energy trauma requiring trauma activation and (2) subsequent operation(s) for pelvi-acetabular fractures internal fixation with (3) at least six months follow up were included. The clinical and functional outcomes of patients who underwent open and minimally invasive surgeries were compared.
Result & Outcome :
101 consecutive patients were enrolled. Thirty-eight (37%) underwent open reduction and internal fixation while the remaining was treated with the MIS technique. The Pelvic Abbreviated Injury Scale of the two groups was 3.87 in the former and 3.62 in the later. Compared with patients with open surgery, patients who received MIS have shorter intensive care unit and total length of stay by two and forty-one days respectively. They have eight percent less surgical complications and superior functional outcome. The fracture union rate in the MIS group is a hundred percent with pain scale of 1.4/10 according to the Numeric Rating Scale. The MIS procedure is a promising surgical procedure for pelvi-acetabular fixation, with proven superior short-term clinical and functional outcome. With the near ten-fold increase in clinical demands in the past decade, the authors anticipate a continuous growth. This cutting edge technique is the solution as it halved the total length of stay and provides highly satisfactory clinical outcome.
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