DENVER — In elderly patients with high energy or fragility fractures of the pelvis, use of retrograde transpubic screws may yield good clinical results with lower or similar complication rates to alternative methods of anterior pelvic ring fixation, according to results presented at the Orthopaedic Trauma Association Annual Meeting, here.
In a retrospective study that analyzed 158 retrograde transpubic screws implanted in 128 patients with either a high energy or fragility fracture of the pelvis, Daniel Wagner, MD, of the University Medical Center Mainz in Mainz, Germany, and colleagues found 8% of screws were implanted at 6 months or more after trauma and 95% of patients had concomitant osteosynthesis.
“Nine patients had to have an open procedure and two-thirds of our screws reached the supra acetabular region,” Wagner said.
Three screws in patients with high energy trauma had local infection and four patients with fragility fractures of the pelvis had local hematoma. Furthermore, revision surgery occurred in seven screws, he said.
“We had a median follow-up of half a year,” Wagner said. “In those with more than half a year follow-up, we saw that 10% were not united radiographically. This was more often seen in patients where the fracture is fixed more than 6 months after trauma.”
According to Wagner, eight screws underwent revision osteosynthesis and debridement and removal of four screws was needed before the fracture healed.
“A total of 11% of patients had the wish to remove the implant usually because they liked to remove the posterior pelvic implants,” Wagner said. – by Casey Tingle
Wagner D, et al. Paper 87. Presented at: Orthopaedic Trauma Association; Sept. 26-28, 2019; Denver.
Disclosure: Wagner reports no relevant financial disclosures.