Robot-assisted treatment of unstable pelvic fractures with a percutaneous iliac lumbar double rod fixation combined with

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ORIGINAL PAPER

Robot-assisted treatment of unstable pelvic fractures with a percutaneous iliac lumbar double rod fixation combined with a percutaneous pelvic anterior ring INFIX fixation Wei Du 1 & Tao Sun 2 & Yan Ding 1 & Chuanqiang Jiang 2 & Wenqing Qu 2 & Shudong Zhang 3 Received: 1 October 2019 / Accepted: 4 March 2020 # The Author(s) 2020

Abstract Objective To investigate the clinical effect of robot-assisted treatment of unstable pelvic fractures through a percutaneous iliac lumbar double rod fixation combined with a percutaneous pelvic anterior ring INFIX (internal fixator) fixation. Methods This was a retrospective analysis of 17 cases of unstable anterior and posterior pelvic ring fractures treated between April 2016 and October 2018 by the third Ti-robot system produced in China. The posterior ring was supported with an iliac lumbar double rod fixation and the anterior ring with an INFIX fixation. Operation time and peri-operative bleeding were recorded. The reduction of pelvic fracture displacement was evaluated by Matta score, the post-operative results were evaluated according to Majeed score, and the complications were recorded. Results Twelve males and five females, aged 21–71 years (mean 40.1 ± 3.8 years) were followed up for three to 12 months, (median 6.7 months). Tile typing showed seven B1 type, two B2 type, and eight C1 type cases. Operation time was 90–160 minutes (mean 112.9 ± 16.8 minutes), bleeding was 80–150 mL (mean 105.9 ± 20.6 mL). X-ray three to five days after operation was evaluated by Matta score as excellent in 15 and good in two cases. Majeed score at last follow-up was 85–98 points, excellent in 17 cases. Two cases of lower extremity deep vein thrombosis received an inferior vena cava filter. The filters were removed after two weeks. One case showed incision fat liquefaction healing and the wound healed three weeks after surgery. Conclusion Orthopedic robot-assisted treatment of unstable pelvic fractures by a percutaneous iliac lumbar double rod fixation and a percutaneous pelvic anterior ring INFIX fixator was minimally invasive and feasible. A prospective study is needed. Keywords Unstable pelvic fracture . Robot-assisted surgery . Minimally invasive surgery . Iliac lumbar fixation . Internal fixator

Introduction Although fractures and injuries of the pelvic ring account for only 2–8% of all fractures [1], an unstable pelvic fracture is associated with a high risk of mortality [2]. Unstable pelvic ring fractures require both anterior and posterior pelvic ring

Wei Du and Tao Sun contributed equally to this work. * Shudong Zhang [email protected] 1

Department of Spine, Yantaishan Hospital, Yantai 264000, Shandong, China

2

Department of Traumatology, Yantaishan Hospital, Yantai 264000, Shandong, China

3

Department of Joint, Yantaishan Hospital, No. 91, Jiefang Road, Yantai 264000, Shandong, China

fixation [1, 3]. Traditional methods include external fixation, anterior and posterior open reduction plate internal fixation, and minimally invasive percutaneous screw fixati