Pelvic unlocking closed reduction device for treatment of severe traumas combined with pelvic fractures: a retrospective case series of 13 patients.

Background: Closed reduction and internal fixation is the key to early and minimally invasive treatment of pelvic fractures in patients with severe trauma. Although the pelvic unlocking closed reduction device has been promoted to a certain extent, the therapeutic effect and surgical strategies for treating severe trauma have not been clearly clarified. Our study was aimed to explore the therapeutic effect and surgical strategy skills of the pelvic unlocking closed reduction device in treating severe traumas combined with pelvic fractures.

Methods: Data were retrospectively collected from 13 patients with severe traumas undergoing pelvic unlocking closed reduction for pelvic fractures in our hospital between July 2021 and December 2022. Seven males and six females aged 48(18~69), 46.4±16.7 years were involved. The operation time, times of fluoroscopy, and blood loss were recorded intraoperatively. Postoperative complications, and fracture healing time were recorded. The Matta and Majeed scales were used to evaluate fracture reduction and clinical efficacy respectively.

Results: The time from injury to surgery was 7(4~14), 8.2±3 days. No wound infection, loosening or breakage of internal fixation, or loss of reduction occurred. The clinical healing time was 3(3~5), 3.5±0.7 months. Three cases suffered paresthesia on unilateral anterolateral thigh. According to the postoperative imaging Matta scores, 12 cases were excellent and 1 case was good, with an excellent rate of 12/13. At the last follow-up, the Majeed functional scores were excellent in all 13 cases.

Conclusions: For patients with severe trauma combined with pelvic fracture, the pelvic unlocking and reduction device can be used for minimally invasive internal fixation at an early stage as long as their vital signs are stable. In this study, we summarized and advocated the 'turn-back order' reduction and internal fixation philosophy of 'posterior-ring unlocking - anterior ring to posterior ring reduction stabilization - posterior ring to anterior ring internal fixation placement' in pelvic closed reduction and internal fixation surgery.