Clinical, Functional and Radiological Outcome of Spinoplevic Fixation in Patients with Vertically Unstable Pelvic Fractures: A Prospective Study of 40 Cases

Background: Vertically unstable pelvic ring fractures have significant impacts on patient’s quality of life. Several techniques have been described for stabilizing posterior pelvic ring injuries especially those with vertical shear pattern. The current study has been designed to evaluate the method of spinopelvic fixation as a method of treatment of complex vertically unstable pelvic injuries. Methods: Between 2014 and 2019, a total of 40 patients with vertically unstable pelvic fractures were treated by spinopelvic fixation at the National Bank Hospital which is a trauma center in Cairo, Egypt. Patients were seen in follow up, on average, for 12 months after surgery. Functional outcome was assessed using Majeed score. Radiological outcome was evaluated by Matta radiological scoring system. Results: The injury was unilateral in 36 patients and bilateral in 4 patients. The mean Majeed score was 82.5/100. The mean Matta radiological score for evaluating postoperative reduction showed excellent reduction in most of patients. Screw prominence occurred in 32 patients (80%) but wound dehiscence and deep infection occurred in 5 (12.5%) and 2 (5%) patients respectively. 9 patients (22.5%) had preoperative neurological deficit of sciatic nerve distribution. 8 of them fully recovered their neurologic deficit within the follow up period. Conclusion: In comminuted patterns of vertical shear pelvic fractures, spinopelvic fixation proved to be an effective means for obtaining a stable rigid fixation with accepted rate of complications compared to other fixation methods. Wound related problems were the commonest associated complications. However, spinopelvic fixation was the only applicable method in specific fractures specially comminuted sacral fractures with neurological deficit.