Comparative Analysis of Surgery Using Combined Iliac Lumbar and Posterior Closed Screws for Pelvic Stability Maintenance.

Abstract

BACKGROUND Pelvic fractures are prevalent complex fractures in traumatic orthopedics that tend to lead to an unstable posterior pelvic ring. This study aimed to analyze and compare the clinical efficacy of combined iliolumbar screws and posterior closure screws in the treatment of pelvic instability. MATERIAL AND METHODS Thirteen (study group) and 22 (control group) patients were treated with combined iliac lumbar screws and posterior closed screws, respectively. Patient baseline information, time between injury and operation, intraoperative blood loss, incision length, operation time, hospitalization days, and preoperative and postoperative visual analogue scale (VAS) scores were collected. RESULTS There were no statistically significant differences in age, sex, mechanism of injury, concomitant injuries, and fracture type. The preoperative VAS score of the study group was 2.46±1.27, while the control group's score was 1.86±0.83 (P=0.101). Postoperative VAS scores increased to 7.46±0.66 and 7.05±1.36, respectively (P=0.311). The operation time for the study group was 213.92 ± 92.53 minutes, longer than the control group's time of 169.09±76.00 minutes (P=0.015). Blood loss in the study group averaged 465.38±240.99 mL, which was greater than the control group's average of 197.27±251.57 mL (P=0.004). The length of the surgical incision in the study group measured 8.62±2.14 cm, compared with 1.52±0.45 cm in the control group (P<0.001). CONCLUSIONS Treatment of pelvic fractures with iliac lumbar combined screws is more complex than other methods. However, this approach offers improved pelvic ring stability, thus facilitating simpler fracture healing. Therefore, it is a viable option for the management of unstable pelvic fractures.