Tratamiento de fracturas del anillo pélvico mediante fijación percutánea: reporte de 12 casos

Abstract

Open reduction and internal fixation (ORIF) are one of the most widely used treatments for pelvic ring fractures, but treatment using percutaneous techniques is gaining more interest and acceptance. Adequate knowledge of the anatomy and of the new surgical techniques for the placement of antegrade or retrograde screws in the acetabular and pelvic bone corridors have allowed the percutaneous technique to be an option in the treatment of these complex fractures.
Material and methods: We conducted a retrospective study, in patients diagnosed with pelvic ring fractures, who were treated by percutaneous fixation with cancellous, cannulated and acutrak screws, open reduction and osteosynthesis were necessary in 4 patients due to the degree of displacement, with a minimum 12 month post-operative follow-up.
Results: We treated 12 patients with a pelvic ring fracture with the percutaneous screw fixation technique, mobility, physiotherapy and discharge from the hospital was carried out earlier, consolidation of the fractures was obtained 3 months after surgery. One patient underwent reoperation for the repositioning of the retrograde screw in the pubis ramus because of
cortical penetration without any repercussion or injury to neurovascular structures. We did not have any case of infection of the surgical site, nor loosening of the implants.
Conclusions: Despite the small number of patients treated percutaneously, we believe that it is a feasible technique to perform it in our environment, it is necessary that the operating room has a translucent table and image intensifier, and the medical staff is trained to do so.