Chinese Journal Of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (1): 9-13.doi: 10.13418/j.issn.1001-165x.2019.01.003

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A modified nailing approach of INFIX and its application in the treatment of pelvic fracture

ZHOU Chun-kui1, ZENG Fei1, HUANG Hua-jian1, LAI Zhong-ming1, LI Ze-yu2, LI Song-jian1   

  1. 1. Department of Orthopedic Trauma, Zhujiang Hospital, Southern Medical University, Guangzhou 510220, China;  2. Department of Anatomy, Southern Medical University, Guangzhou 510515, China
  • Received:2018-08-11 Online:2019-01-25 Published:2019-02-20

Abstract:

Objective To explore the feasibility of INFIX nailing into the space between sartorius and iliopsoas muscle, and to evaluate its clinical efficacy and complications. Methods  The distance from the medial and lateral margins of sartorius to the lateral femoral cutaneous nerve and femoral nerve were measured on gross specimens, and the differences among groups were compared with t-test. Then, the clinical data of 14 pelvic fracture patients treated with INFIX were collected from Zhujiang Hospital of Southern Medical University from August 2016 to December 2018. Evaluation of clinical efficacy depended on the pelvic deformity index (PDI) and the width of pubic symphysis, as well as the weighting time, the time to remove internal fixation and the Majeed score after INFIX. Complications included the injury to lateral femoral cutaneous nerve (LFCN), the injury to femoral nerve, and so on. Results Compared to the lateral margin of sartorius, the distance from medial margin to LFCN increased 7.71 mm (P<0.01), and to the femoral nerve still remained 22.36 mm. After INFIX, the PDI decreased 1.82%(P<0.01), the width of pubic symphysis decreased 6.98 mm (P<0.05), the average weighting time was 12.70 week, the time to remove internal fixation was 29.50 week, and the Majeed score was 90.80. There was no injury of LFCN and the femoral nerve, 2 patients had incisional infection, and 1 patient had subjective discomfort.    Conclusion    The INFIX nailing into the space between sartorius and iliopsoas muscle can reduce the risk of injury to LFCN, and does not interfere with the femoral nerve. It has several advantages for anterior pelvic ring fracture including minimal invasion, good curative effect, and few complications.

Key words: Approach,  Sartorius,  LFCN,  Pelvic fracture