Pelvic Ring Fractures, Pelvic Ring Injury
Conditions
Keywords
pelvic ring injuries, vertical shear pelvic fracture, tile classification
Brief summary
The goal of this study is to compare the sequence of fixation in Vertically Unstable Tile C1.2 and C1.3 pelvic ring injuries, as regards clinical, radiological outcomes and implant failure rates. Our hypothesis is that starting with anterior ring fixation will achieve superior results as regards easier reduction, less operation time, and finally better radiological and functional outcomes when compared with starting with posterior ring fixation.
Interventions
PROCEDUREStarting by anterior ring fixation in vertical shear pelvic ring injuries
The procedure will involve addressing the pelvic ring anteriorly with open reduction and internal fixation (ORIF) of the pubic rami and symphysis pubis by using a single 3.5 mm recon plate. The goal isto achieve anatomical reduction and stable fixation to restore the integrity of the pelvic ring. Fixation of the posterior ring will be achieved using a single sacroiliac screw in S1. The goal of posterior fixation is to achieve stability and alignment of the posterior pelvic structures.
PROCEDUREStarting by posterior ring fixation in vertical shear pelvic ring injuries
the procedure will involve fixation of the posterior ring which will be achieved by using a single sacroiliac screw in S1. Then open reduction and internal fixation (ORIF) of the pubic rami and symphysis pubis by using a single 3.5 mm recon plate.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Age: 18 years - 60 years. 2. Tile C1.2 and C1.3 pelvic ring injuries. 3. Pure anterior ring ligamentous injuries.
Exclusion criteria
1. Bony fracture of the pubic rami. 2. Tile C2 and C3 pelvic ring injuries. 3. Associated acetabular fracture that requires intervention.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiological outcome scores | 12 months | Patients will be followed up at two weeks, six weeks, three months, six months and one year postoperatively. Matta & Tornetta radiological principles will be used to assess the radiological and clinical outcomes via plain X-ray of pelvis showing both hips through anteroposterior, inlet and outlet views. Evaluation of five criteria on X-ray films postoperatively: residual posterior displacement, vertical displacement, pubic symphyseal translation, sagittal rotation and gapping of the sacroiliac joint. According to the grading of Matta & Tornetta principles, results will be as follows; excellent (\< 4 mm), good (4 - 10 mm), fair (10- 20 mm), and poor (\> 20 mm). |
| Clinical outcome score | 12 months | Clinical outcome assessment at final follow up using Majeed pelvic score. Five factors are assessed and scored: pain, standing, sitting, sexual intercourse and work performance. The total score is then given a clinical grade as excellent, good, fair or poor. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Operative time in minutes. | 3 hours | Operative time will be recorded in each group |
| Implant failure rate | 12 months | Implant failure if any, will be recorded during follow up. |
Countries
Egypt
Contacts
Primary ContactKarim Salem, Masters of Orthopedic surgery
Outcome results
None listed