Clinical effects of Starr frame-assisted reduction combined with channel screw technique in the treatment of Tile C1.3 pelvic fractures
Objective To investigate the efficacy and safety of Starr frame-assisted reduction combined with minimally invasive channel screw technique in the treatment of Tile C1.3 pelvic fractures. Methods This ret-rospective analysis was conducted on 34 patients with Tile C1.3 pelvic fractures who underwent surgical treatment at the Department of Orthopedics,Affiliated Hospital of North Sichuan Medical College,between Jan. 2019 and Jan. 2023. Of these patients,23 were male and 11 were female,aged 21-68 (mean 42.6) years. The causes of injuries included road traffic accidents in 19 cases,falls from height in 7 cases,and ground-level falls in 8 cases. Among them,11 cases had concomitant limb fractures,12 spinal fractures,6 abdominal trauma,and 2 peroneal nerve inju-ries. Eighteen cases were treated with Starr frame-assisted reduction combined with channel screw fixation and in-cluded in the study group,while the other 16 cases underwent traditional open reduction and internal fixation and were included in the control group. Perioperative parameters including operation time,intraoperative blood loss,intr-aoperative fluoroscopy times,and length of hospital stay were analyzed for both groups. Pre-and post-operative sa-cral vertical displacement was measured via CT scans. Fracture reduction quality was assessed using the Matta score. Complications such as surgical site infection,vascular or nerve injury,lower limb deep vein thrombosis,and heterotopic ossification were recorded. Fracture healing time and functional recovery were compared between the two groups using the Majeed functional score. Results Compared with the control group,the study group revealed sig-nificantly shorter operation time (min,73.0±13. 6 vs. 138. 3±47. 6),less intraoperative blood loss (mL,25. 0±12.5 vs. 226.5±102.4),and shorter length of hospital stay(d,median 12.1 vs. median 23.2,all P<0.001). How-ever,the study group required much more numbers of intraoperative fluoroscopy(median 31.2 vs. median 25.0,P=0.009). There was no significant difference in pre-and post-operative sacral vertical displacement change between the study (mm,preoperative 10.2±6.2 and postoperative 4.7±3.1) and control groups (mm,preoperative 9.7±5.8 and postoperative 5.1±3.4),P>0.05. The rate of excellent and good fracture reduction was 88.9％ in the study group and 81.3％ in the control group,revealing no significant significance(z=-1. 116,P=0. 265). The overall complication rates were 11.1％ in the study group and 25.0％ in the control group,with no significant difference ei-ther (x2=1.500,P=0.682). All patients were followed up for 6-17(mean 11.6) months,which found much quic-ker fracture healing in the study group than in the control group (weeks,mean 16.3 vs. mean 22.3,P=0.005),and much higher Majeed score at final follow-up (85.3±6.4 vs. 80.6±5.7,P=0.032). Conclusion Starr frame-as-sisted reduction combined with percutaneous channel screw fixation is a promising approach to managing Tile C1.3 pelvic fractures,which presents minimal intraoperative blood loss,short surgical and hospitalization duration,and sig-nificantly accelerated fracture healing. These findings endorse the concept of expedited rehabilitation and suggest good clinical outcomes.
万方数据
维普
