Theodoros H Tosounidis1, Hassaan Qaiser Sheikh2, Nikolaos K Kanakaris3, Peter V Giannoudis4. 1. Academic Department of Trauma & Orthopaedic Surgery, Clarendon Wing, Floor D, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA West Yorkshire, Leeds, UK. Electronic address: ttosounidis@yahoo.com. 2. Academic Department of Trauma & Orthopaedic Surgery, Clarendon Wing, Floor D, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, UK. Electronic address: hqsheikh@gmail.com. 3. Academic Department of Trauma & Orthopaedic Surgery, Clarendon Wing, Floor D, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, UK. Electronic address: nikolaoskanakaris@yahoo.co.uk. 4. Academic Department of Trauma & Orthopaedic Surgery, Clarendon Wing, Floor D, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA West Yorkshire, Leeds, UK. Electronic address: pgiannoudi@aol.com.
Abstract
OBJECTIVES: To analyse the complications and outcomes (functional/radiographic) of Pelvic External Fixators applied as part of the definitive fixation in polytrauma patients. DESIGN: A single center retrospective chart review. SETTING: A level-1 trauma center. PATIENTS AND METHODS: We reviewed all the polytrauma patients (ISS>16) between 2007 and 2012 that had a PEF applied more than 30days. Complications including infection, aseptic loosening, neurological injury, loss of reduction, non-union and mal-union were recorded. Pelvic asymmetry and Deformity Index (DI) were measured at the immediate postoperative radiographs and final follow-up. The functional outcome at final follow up was estimated using a scale previously reported by Chiou et al. RESULTS: 59 patients with mean age of 38.4 (16 - 81) years and mean ISS score 28 (16- 66) were included. The PEFs were applied for mean duration of 56 (30-104) days. The average follow-up was 403days. 22 injuries were type B and 37 type C (AO/OTA). The most common symptomatic complications were pin site infection in 11 (18.6%) and loosening in 5 (8.5%) cases. 44 (74.5%) patients had satisfactory functional outcome. The immediate post-operative and final asymmetry and DI were compared between the two pelvic injury groups (type B and C fractures). The difference in displacement progression was more for type C injuries (p=0.034) but no correlation to the functional outcome was evident. CONCLUSION: PEF can be used as definitive alternative stabilization method in specific situations at polytrauma setting. Radiological displacement occurred in both type B and C injuries but the clinical outcome was not correlated to this displacement. Complications related to PEF do not affect the final clinical outcome. LEVEL OF EVIDENCE: Therapeutic Level III.
OBJECTIVES: To analyse the complications and outcomes (functional/radiographic) of Pelvic External Fixators applied as part of the definitive fixation in polytraumapatients. DESIGN: A single center retrospective chart review. SETTING: A level-1 trauma center. PATIENTS AND METHODS: We reviewed all the polytraumapatients (ISS>16) between 2007 and 2012 that had a PEF applied more than 30days. Complications including infection, aseptic loosening, neurological injury, loss of reduction, non-union and mal-union were recorded. Pelvic asymmetry and Deformity Index (DI) were measured at the immediate postoperative radiographs and final follow-up. The functional outcome at final follow up was estimated using a scale previously reported by Chiou et al. RESULTS: 59 patients with mean age of 38.4 (16 - 81) years and mean ISS score 28 (16- 66) were included. The PEFs were applied for mean duration of 56 (30-104) days. The average follow-up was 403days. 22 injuries were type B and 37 type C (AO/OTA). The most common symptomatic complications were pin site infection in 11 (18.6%) and loosening in 5 (8.5%) cases. 44 (74.5%) patients had satisfactory functional outcome. The immediate post-operative and final asymmetry and DI were compared between the two pelvic injury groups (type B and C fractures). The difference in displacement progression was more for type C injuries (p=0.034) but no correlation to the functional outcome was evident. CONCLUSION: PEF can be used as definitive alternative stabilization method in specific situations at polytrauma setting. Radiological displacement occurred in both type B and C injuries but the clinical outcome was not correlated to this displacement. Complications related to PEF do not affect the final clinical outcome. LEVEL OF EVIDENCE: Therapeutic Level III.
Authors: P L N Fernando; Aravinda Abeygunawardane; Pci Wijesinghe; Parakrama Dharmaratne; Pujitha Silva Journal: Med Eng Phys Date: 2021-11-04 Impact factor: 2.242
Authors: Daniel Wagner; Andreas Höch; Philipp Pieroh; Tim Hohmann; Florian Gras; Sven Märdian; Alexander Pflug; Silvan Wittenberg; Christoph Ihle; Notker Blankenburg; Kevin Dallacker-Losensky; Tanja Schröder; Steven C Herath; Hans-Georg Palm; Christoph Josten; Fabian M Stuby Journal: Sci Rep Date: 2022-02-11 Impact factor: 4.379
Authors: Benjamin W Hoyt; Alexander E Lundy; Richard L Purcell; Colin J Harrington; Wade T Gordon Journal: Clin Orthop Relat Res Date: 2020-04 Impact factor: 4.755