Abstract：
BACKGROUND: Superior and inferior ramus fractures, termed straddle fractures, are high-energy fractures often accompanied by unstable pelvic ring injuries. However, consensus is lacking regarding indications for surgical treatment or fixation methods. We aimed to compare clinical and radiological outcomes of unilateral ramus fixation (URF) and bilateral ramus fixation (BRF) for straddle fractures with unilateral posterior pelvic ring injuries.
METHODS: We enrolled 118 patients (73 males, 45 females; mean age, 47 years) diagnosed with straddle fractures between March 2015 and December 2021 with > 1 year of follow-up. Patients were divided into URF (n = 60) and BRF (n = 58) groups based on the anterior pelvic ring fixation method. Preoperative factors including body mass index, diabetes, smoking, injury mechanism, injury severity score, American Society of Anesthesiologists classification system, Tile classification, and Young and Burgess classification were compared. Intraoperative blood loss, operation time, postoperative bone union rate, complications, and the need for additional surgeries were analyzed.
RESULTS: There were no statistically significant preoperative differences between the two groups. However, the URF group showed a significantly lower mean operative time and blood transfusion requirement (63 min and 2 units, respectively) than the BRF group (104 min and 3 units, respectively) (both p < 0.001). Postoperatively, bone union was achieved in 57 (95.0%) and 56 (96.6%) patients in the URF and BRF groups, respectively. Complications occurred in 17 (28.3%) and 14 (24.1%) patients in the URF and BRF groups, respectively, with additional surgeries needed in 3 (5.0%) patients in the URF group and 2 (3.4%) patients in the BRF group.
CONCLUSIONS: Unilateral anterior fixation can provide sufficient stability and clinical effectiveness in the surgical treatment of straddle fractures in areas with posterior pelvic ring injuries. Compared with bilateral anterior fixation, unilateral fixation significantly reduces operation time and blood loss, making it a viable fixation method for straddle fractures.
METHODS: We enrolled 118 patients (73 males, 45 females; mean age, 47 years) diagnosed with straddle fractures between March 2015 and December 2021 with > 1 year of follow-up. Patients were divided into URF (n = 60) and BRF (n = 58) groups based on the anterior pelvic ring fixation method. Preoperative factors including body mass index, diabetes, smoking, injury mechanism, injury severity score, American Society of Anesthesiologists classification system, Tile classification, and Young and Burgess classification were compared. Intraoperative blood loss, operation time, postoperative bone union rate, complications, and the need for additional surgeries were analyzed.
RESULTS: There were no statistically significant preoperative differences between the two groups. However, the URF group showed a significantly lower mean operative time and blood transfusion requirement (63 min and 2 units, respectively) than the BRF group (104 min and 3 units, respectively) (both p < 0.001). Postoperatively, bone union was achieved in 57 (95.0%) and 56 (96.6%) patients in the URF and BRF groups, respectively. Complications occurred in 17 (28.3%) and 14 (24.1%) patients in the URF and BRF groups, respectively, with additional surgeries needed in 3 (5.0%) patients in the URF group and 2 (3.4%) patients in the BRF group.
CONCLUSIONS: Unilateral anterior fixation can provide sufficient stability and clinical effectiveness in the surgical treatment of straddle fractures in areas with posterior pelvic ring injuries. Compared with bilateral anterior fixation, unilateral fixation significantly reduces operation time and blood loss, making it a viable fixation method for straddle fractures.
摘要：
背景：上支和下支骨折，称为跨式骨折，高能量骨折常伴有不稳定的骨盆环损伤。然而,关于手术治疗或固定方法的适应症缺乏共识。我们旨在比较单侧后骨盆环损伤的跨骑骨折的单侧支固定（URF）和双侧支固定（BRF）的临床和放射学结果。
方法：我们招募了118名患者（73名男性，45名女性；平均年龄，47年）在2015年3月至2021年12月之间诊断为跨骑骨折，随访时间>1年。根据骨盆前环固定方法将患者分为URF组(n=60)和BRF组(n=58)。术前因素包括体重指数，糖尿病,吸烟,损伤机制,损伤严重程度评分,美国麻醉医师学会分类系统，瓷砖分类,比较了Young和Burgess分类。术中失血,操作时间,术后骨愈合率，并发症,并分析了是否需要额外的手术。
结果：两组术前差异无统计学意义。然而,URF组的平均手术时间和输血需求显着降低（63分钟和2个单位，分别)比BRF组(104分钟和3个单位，分别)(两者p<0.001)。术后,在URF和BRF组中，57例（95.0%）和56例（96.6%）患者实现了骨愈合，分别。在URF和BRF组中有17例（28.3%）和14例（24.1%）患者发生并发症，分别,URF组3例(5.0%)患者和BRF组2例(3.4%)患者需要额外手术.
结论：单侧前路内固定术在骨盆后环损伤区跨骑骨折的手术治疗中可以提供足够的稳定性和临床有效性。与双侧前路固定相比，单侧固定显著减少手术时间和失血，使其成为治疗跨骑骨折的可行固定方法。
方法：我们招募了118名患者（73名男性，45名女性；平均年龄，47年）在2015年3月至2021年12月之间诊断为跨骑骨折，随访时间>1年。根据骨盆前环固定方法将患者分为URF组(n=60)和BRF组(n=58)。术前因素包括体重指数，糖尿病,吸烟,损伤机制,损伤严重程度评分,美国麻醉医师学会分类系统，瓷砖分类,比较了Young和Burgess分类。术中失血,操作时间,术后骨愈合率，并发症,并分析了是否需要额外的手术。
结果：两组术前差异无统计学意义。然而,URF组的平均手术时间和输血需求显着降低（63分钟和2个单位，分别)比BRF组(104分钟和3个单位，分别)(两者p<0.001)。术后,在URF和BRF组中，57例（95.0%）和56例（96.6%）患者实现了骨愈合，分别。在URF和BRF组中有17例（28.3%）和14例（24.1%）患者发生并发症，分别,URF组3例(5.0%)患者和BRF组2例(3.4%)患者需要额外手术.
结论：单侧前路内固定术在骨盆后环损伤区跨骑骨折的手术治疗中可以提供足够的稳定性和临床有效性。与双侧前路固定相比，单侧固定显著减少手术时间和失血，使其成为治疗跨骑骨折的可行固定方法。
