{"title":"Posterior pelvic ring fixation: evolution of surgical approaches and evidence-based outcomes for unstable fractures.","authors":"Haiyan Zhou, Liming Cheng","doi":"10.3389/fsurg.2025.1653169","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical outcomes of a novel percutaneous posterior minimally invasive approach for unstable posterior pelvic ring fractures (Tile Type C).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 19 consecutive patients treated between 2015 and 2022 at a tertiary trauma center. Inclusion criteria included: 1) adults with Tile C1.1-C1.3 fractures; 2) hemodynamic stability; and 3) minimum 12-month follow-up. Surgical technique featured bilateral 4-cm incisions, subperiosteal tunneling, and anatomically contoured locking plates. Primary outcomes were radiographic union (Matta criteria) and functional recovery (Majeed Pelvic Score).</p><p><strong>Results: </strong>The study demonstrated excellent outcomes across all evaluated parameters. All 19 patients achieved bony union within 15.8 ± 4.5 weeks, with 94.7% (18/19) obtaining excellent functional recovery (Majeed score >80). No neurovascular complications or implant failures occurred during the 20-month follow-up. All patients successfully progressed through rehabilitation, achieving full weight-bearing by 12 weeks postoperatively.</p><p><strong>Conclusion: </strong>The percutaneous posterior approach provides effective stabilization for rotationally unstable pelvic fractures with minimal morbidity. While demonstrating advantages in blood loss, operative time, and early mobilization compared to traditional techniques, its applicability remains limited to Tile C1 patterns without vertical instability.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1653169"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463939/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1653169","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the clinical outcomes of a novel percutaneous posterior minimally invasive approach for unstable posterior pelvic ring fractures (Tile Type C).
Methods: This retrospective cohort study analyzed 19 consecutive patients treated between 2015 and 2022 at a tertiary trauma center. Inclusion criteria included: 1) adults with Tile C1.1-C1.3 fractures; 2) hemodynamic stability; and 3) minimum 12-month follow-up. Surgical technique featured bilateral 4-cm incisions, subperiosteal tunneling, and anatomically contoured locking plates. Primary outcomes were radiographic union (Matta criteria) and functional recovery (Majeed Pelvic Score).
Results: The study demonstrated excellent outcomes across all evaluated parameters. All 19 patients achieved bony union within 15.8 ± 4.5 weeks, with 94.7% (18/19) obtaining excellent functional recovery (Majeed score >80). No neurovascular complications or implant failures occurred during the 20-month follow-up. All patients successfully progressed through rehabilitation, achieving full weight-bearing by 12 weeks postoperatively.
Conclusion: The percutaneous posterior approach provides effective stabilization for rotationally unstable pelvic fractures with minimal morbidity. While demonstrating advantages in blood loss, operative time, and early mobilization compared to traditional techniques, its applicability remains limited to Tile C1 patterns without vertical instability.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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