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Archives of Orthopaedic and Trauma Surgery

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09-01-2024 | Pelvic Asymmetry | Trauma Surgery

Open reduction and internal fixation of crescent fracture-dislocation: anterior or posterior approach?

Authors: Kai Ye, Jianfei Tang, Longxiang Shen, Zhiquan An

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2024

Abstract

Introduction

To date, the approach that prevails in the open reduction and internal fixation of crescent fracture-dislocations (CFD) remains unknown. This study aimed to compare the outcomes of CFD treated via the anterior or posterior approach.

Materials and methods

Data from 64 cases of CFDs openly reduced through an anterior (group A, n = 31) or a posterior (group B, n = 33) approach were retrospectively analyzed. Functional results, reduction quality, residual displacements in the axial and coronal planes, pelvic asymmetry deformity, and correlations between Day’s classification were compared. Complications and fracture union were also recorded. All patients were followed up for at least 12 months.

Results

The functional scores were similar between the two groups, and all fractures achieved good or excellent reduction postoperatively. In the coronal plane, the excellent/good ratio in group B was higher than in group A. The mean residual displacement in the coronal plane was significantly higher in group A than in group B, with group A showing greater displacement in both planes for Day I fractures and in the coronal plane for Day II fractures. The residual displacement in both planes for Day III fractures was comparable between the groups. The pelvic asymmetry deformity was equal between the two groups and among the different Day’s fracture types.

Conclusions

Open reduction and internal fixation of CFDs obtained satisfactory outcomes through an anterior or posterior approach. The posterior approach achieved a better sacroiliac joint reduction. The optimal indication for the posterior approach was a Day I fracture, followed by a Day II fracture. No correlation was found between the surgical approach and reduction quality in Day III fractures.

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Title: Open reduction and internal fixation of crescent fracture-dislocation: anterior or posterior approach?
Authors: Kai Ye
Jianfei Tang
Longxiang Shen
Zhiquan An
Publication date: 09-01-2024
Publisher: Springer Berlin Heidelberg
Keyword: Pelvic Asymmetry
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 3/2024
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-05185-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Open reduction and internal fixation of crescent fracture-dislocation: anterior or posterior approach?

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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