Three-axis displacement classification of pelvic fracture and its reduction principles_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 XIANG Zhou ¹ , DUAN Xin ¹ , WANG Hong ²

1. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;
2. West China School of Medicine, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding?author：

XIANG Zhou, Email: xiangzhou15@hotmail.com

Keywords：

Pelvis fracture; CT three-dimensional reconstruction; three-axis displacement; reduction

DOI：

10.7507/1002-1892.201612030

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective Based on images of pelvic CT three-dimensional reconstruction, to establish three-dimensional coordinate system of pelvis and investigate the three-axis displacement classification of pelvic fracture and its reduction principles. Methods Between June 2015 and May 2016, 21 cases of normal pelvic CT data were included in the study, and the mean pelvic three-dimensional model was established. The pelvic three-dimensional axis was established by defining the origin as the midpoint of the anterior superior iliac spine. Based on this coordinate system, a three-axis displacement classification of pelvic fracture were built. To assess the clinical guidance value of the three-axis classification, 55 cases (29 males and 26 females, aged 11-66 years with an average of 35.6 years) of pelvic fractures were analyzed by this classification, and replaced and fixed according to the principles of the reverse reduction. Results According to the theory of three-axis, pelvic fractures were divided into x-axis positive displacement/negative displacement, positive rotation/negative rotation; y-axis positive displacement/negative displacement, positive rotation/negative rotation; z-axis positive displacement/negative displacement, positive rotation/negative rotation. The average incision of included patients with pelvic fractures was 7.1 cm. The average reduction time was 12.2 minutes and the average radiation time was 55.3 s. The average time of screw implantation was 27.2 minutes. Postoperative pelvic X-ray films or three-dimensional CT showed all pelvic fracture was reducted well and the screw or plate was implanted correctly. The average intraoperative blood loss was 96.5 mL, the average operation time was 2.1 hours, and the average hospitalization time was 18.7 days. All patients were followed up 6-53 months (mean, 16.7 months). At last follow-up, according to Matta standard by pelvic radiography evaluation, there were excellent in 39 cases, good in 13 cases, and fair in 3 cases, the excellent and good rate was 94.55%. Conclusion Based on three-dimensional coordinate system, three-axis displacement classification of pelvic fracture can illustrate the displacement mode of patient simply and accurately, and can also guide the intraoperative reduction precisely.

Citation： XIANG Zhou, DUAN Xin, WANG Hong. Three-axis displacement classification of pelvic fracture and its reduction principles. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(10): 1153-1160. doi: 10.7507/1002-1892.201612030 Copy

1.	Wong JM, Bucknill A. Fractures of the pelvic ring. Injury, 2017, 48(4): 795-802.
2.	Pohlemann T, Stengel D, Tosounidis G, et al. Survival trends and predictors of mortality in severe pelvic trauma: estimates from the German Pelvic Trauma Registry Initiative. Injury, 2011, 42(10): 997-1002.
3.	Balogh Z, King KL, Mackay P, et al. The epidemiology of pelvic ring fractures: a population-based study. J Trauma, 2007, 63(5): 1066-1073.
4.	Yoshihara H, Yoneoka D. Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality. J Trauma Acute Care Surg, 2014, 76(2): 380-385.
5.	陳惟昌, 陳志華, 趙天德, 等. 可視化人體的整體坐標系統. Ct 理論與應用研究, 2004, 13(1): 1-6.0.
6.	徐青鐳, 倪衛明, 萬年宇. 人體髖關節周圍肌肉三維生物力學模型的建立與應用. 傷殘醫學雜志, 2003, 11(3): 13-14.0.
7.	Zheng G. Assessing the accuracy factors in the determination of postoperative acetabular cup orientation using hybrid 2D-3D registration. J Digit Imaging, 2010, 23(6): 769-779.
8.	Borhani M, Mcgregor AH, Bull AM. An alternative technical marker set for the pelvis is more repeatable than the standard pelvic marker set. Gait Posture, 2013, 38(4): 1032-1037.
9.	高金華, 郭曉山, 梁清宇, 等. 基于 X 線片與 CT 的不穩定型骨盆骨折 3D 分型研究. 中華創傷骨科雜志, 2013, 15(11): 961-966.0.
10.	石成弟, 胡煒, 余可和, 等. 不穩定型骨盆骨折三維空間移位的 X 線診斷方法及其在閉合復位術中的初步應用. 中華創傷雜志, 2013, 29(8): 717-722.0.

1. Wong JM, Bucknill A. Fractures of the pelvic ring. Injury, 2017, 48(4): 795-802.
2. Pohlemann T, Stengel D, Tosounidis G, et al. Survival trends and predictors of mortality in severe pelvic trauma: estimates from the German Pelvic Trauma Registry Initiative. Injury, 2011, 42(10): 997-1002.
3. Balogh Z, King KL, Mackay P, et al. The epidemiology of pelvic ring fractures: a population-based study. J Trauma, 2007, 63(5): 1066-1073.
4. Yoshihara H, Yoneoka D. Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality. J Trauma Acute Care Surg, 2014, 76(2): 380-385.
5. 陳惟昌, 陳志華, 趙天德, 等. 可視化人體的整體坐標系統. Ct 理論與應用研究, 2004, 13(1): 1-6.0.
6. 徐青鐳, 倪衛明, 萬年宇. 人體髖關節周圍肌肉三維生物力學模型的建立與應用. 傷殘醫學雜志, 2003, 11(3): 13-14.0.
7. Zheng G. Assessing the accuracy factors in the determination of postoperative acetabular cup orientation using hybrid 2D-3D registration. J Digit Imaging, 2010, 23(6): 769-779.
8. Borhani M, Mcgregor AH, Bull AM. An alternative technical marker set for the pelvis is more repeatable than the standard pelvic marker set. Gait Posture, 2013, 38(4): 1032-1037.
9. 高金華, 郭曉山, 梁清宇, 等. 基于 X 線片與 CT 的不穩定型骨盆骨折 3D 分型研究. 中華創傷骨科雜志, 2013, 15(11): 961-966.0.
10. 石成弟, 胡煒, 余可和, 等. 不穩定型骨盆骨折三維空間移位的 X 線診斷方法及其在閉合復位術中的初步應用. 中華創傷雜志, 2013, 29(8): 717-722.0.

Next Article
Application of Orthofix unilateral external fixator in the treatment of musculoskeletal tumors

Chinese Journal of Reparative and Reconstructive Surgery

Three-axis displacement classification of pelvic fracture and its reduction principles

Abstract Full text Figures/Tables Video References Cited by

Next Article

Format

Content