Abstract：
OBJECTIVE: The role of transobturator-cable-fixation (TOCF) in traumatic symphyseal rupture of the pelvic ring remains unclear. This case series aims to evaluate TOCF in complex and revision cases in pelvic surgery.
METHODS: A retrospective analysis of a chronological case series was conducted, studying pelvic fractures stabilized using TOCF between January 2006 and December 2022. The variables considered included age, gender, fracture classification, Injury Severity Score (ISS), Body Mass Index (BMI), trauma mechanism, time to surgery, fixation technique, hospital duration, complications, status on discharge (Glasgow Outcome Scale; GOS), follow-up time and indication for the use of TOCF.
RESULTS: All patients (N = 7) were male with a mean age of 64 years and a mean BMI of 29. The mean ISS was 45, with the lowest ISS of 25, indicating that only polytraumatized patients were included. Two anterior-posterior-compression-, four lateral-compression-, and one vertical-shear-pelvic-injury were identified. TOCF was added in six cases to support symphyseal plating and in one case to external fixation. The mean hospital stay was 49 days and the mean follow-up duration was 8.5 months. No complications associated with TOCF were observed during the surgical procedure or follow-up.
CONCLUSIONS: TOCF showed no procedure-associated complications and effectively supported symphyseal healing in all cases. The main indications were obesity, poor bone quality in elderly patients, and revision cases. TOCF could be considered as a last treatment option in open-book pelvic injuries where plating or external fixation is at risk to fail.
METHODS: A retrospective analysis of a chronological case series was conducted, studying pelvic fractures stabilized using TOCF between January 2006 and December 2022. The variables considered included age, gender, fracture classification, Injury Severity Score (ISS), Body Mass Index (BMI), trauma mechanism, time to surgery, fixation technique, hospital duration, complications, status on discharge (Glasgow Outcome Scale; GOS), follow-up time and indication for the use of TOCF.
RESULTS: All patients (N = 7) were male with a mean age of 64 years and a mean BMI of 29. The mean ISS was 45, with the lowest ISS of 25, indicating that only polytraumatized patients were included. Two anterior-posterior-compression-, four lateral-compression-, and one vertical-shear-pelvic-injury were identified. TOCF was added in six cases to support symphyseal plating and in one case to external fixation. The mean hospital stay was 49 days and the mean follow-up duration was 8.5 months. No complications associated with TOCF were observed during the surgical procedure or follow-up.
CONCLUSIONS: TOCF showed no procedure-associated complications and effectively supported symphyseal healing in all cases. The main indications were obesity, poor bone quality in elderly patients, and revision cases. TOCF could be considered as a last treatment option in open-book pelvic injuries where plating or external fixation is at risk to fail.
摘要：
目的：经闭孔-索固定（TOCF）在外伤性骨盆环联合破裂中的作用尚不清楚。本病例系列旨在评估骨盆手术中复杂和翻修病例的TOCF。
方法：对一个按时间顺序排列的病例系列进行回顾性分析，研究2006年1月至2022年12月期间使用TOCF稳定的骨盆骨折.考虑的变量包括年龄，性别,断裂分类,伤害严重程度评分（ISS），身体质量指数(BMI),创伤机制，手术时间到了,固定技术，住院时间,并发症,出院状态(格拉斯哥结果量表；GOS)，随访时间和使用TOCF的指征。
结果：所有患者（N=7）均为男性，平均年龄为64岁，平均BMI为29。平均ISS为45，最低ISS为25，表明仅包括多创伤患者。两个前后按压-，四次横向按压-，并确定了一个垂直剪切骨盆损伤。6例增加了TOCF以支持联合植骨钢板，1例增加了外固定。平均住院时间为49天，平均随访时间为8.5个月。在外科手术或随访期间未观察到与TOCF相关的并发症。
结论：TOCF在所有病例中均未显示与手术相关的并发症，并有效支持联合愈合。主要适应症是肥胖，老年患者骨质量差，和修订案例。TOCF可被视为开放式骨盆损伤的最后一种治疗选择，在这种情况下，钢板或外固定有失败的风险。
方法：对一个按时间顺序排列的病例系列进行回顾性分析，研究2006年1月至2022年12月期间使用TOCF稳定的骨盆骨折.考虑的变量包括年龄，性别,断裂分类,伤害严重程度评分（ISS），身体质量指数(BMI),创伤机制，手术时间到了,固定技术，住院时间,并发症,出院状态(格拉斯哥结果量表；GOS)，随访时间和使用TOCF的指征。
结果：所有患者（N=7）均为男性，平均年龄为64岁，平均BMI为29。平均ISS为45，最低ISS为25，表明仅包括多创伤患者。两个前后按压-，四次横向按压-，并确定了一个垂直剪切骨盆损伤。6例增加了TOCF以支持联合植骨钢板，1例增加了外固定。平均住院时间为49天，平均随访时间为8.5个月。在外科手术或随访期间未观察到与TOCF相关的并发症。
结论：TOCF在所有病例中均未显示与手术相关的并发症，并有效支持联合愈合。主要适应症是肥胖，老年患者骨质量差，和修订案例。TOCF可被视为开放式骨盆损伤的最后一种治疗选择，在这种情况下，钢板或外固定有失败的风险。
