ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1653169
Posterior Pelvic Ring Fixation: Evolution of Surgical Approaches and Evidence-Based Outcomes for Unstable Fractures
Provisionally accepted
- 1School of Medicine, Tongji University, shanghai, China
- 2Tongji Hospital Affiliated to Tongji University, Shanghai, China
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Abstract Objective: To evaluate the clinical outcomes of a novel percutaneous posterior minimally invasive approach for unstable posterior pelvic ring fractures (Tile Type C). Methods: This retrospective cohort study analyzed 19 consecutive patients treated between 2015-2022 at a tertiary trauma center. Inclusion criteria included: 1) adults with Tile C1.1-C1.3 fractures; 2) hemodynamic stability; and 3) minimum 12-month follow-up. Surgical technique featured bilateral 4-cm incisions, subperiosteal tunneling, and anatomically contoured locking plates. Primary outcomes were radiographic union (Matta criteria) and functional recovery (Majeed Pelvic Score). Results：The study demonstrated excellent outcomes across all evaluated parameters. All 19 patients achieved bony union within 15.8±4.5 weeks, with 94.7% (18/19) obtaining excellent functional recovery (Majeed score >80). No neurovascular complications or implant failures occurred during the 20-month follow-up. All patients successfully progressed through rehabilitation, achieving full weight-bearing by 12 weeks postoperatively. Conclusion: The percutaneous posterior approach provides effective stabilization for rotationally unstable pelvic fractures with minimal morbidity. While demonstrating advantages in blood loss, operative time, and early mobilization compared to traditional techniques, its applicability remains limited to Tile C1 patterns without vertical instability. Keywords: pelvic fracture; minimally invasive surgery; internal fixation; sacroiliac joint; trauma
Keywords: Pelvic fracture, minimally invasive surgery, internal fixation, Sacroiliac Joint, Trauma
Received: 24 Jun 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Zhou and cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Liming cheng, Tongji Hospital Affiliated to Tongji University, Shanghai, China
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