الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Combined posterior & anterior ring fixation is classically performed in Tile B2 & C1 injuries to achieve superior biomechanical stability. However, it is unclear whether isolated posterior ring fixation can achieve comparable radiological and clinical outcomes or not. Therefore, we conducted this study to compare the two fixation principles in managing Tile B2 and C1 injuries. Patients and Methods: We conducted a randomized clinical trial between February 2017 and January 2019; 40 patients with Tile B2 & C1 injuries underwent intervention at a level one trauma center (mean age:30). Random allocation into two groups by block randomization; 20 cases via combined posterior & anterior ring fixation (group A), while the other 20 via isolated posterior ring fixation (group B). We compared the outcomes between the two groups primarily in terms: radiological & clinical outcomes and postoperative complications. Results: Our study included 20 patients with Tile B2 & 20 patients with Tile C1 injuries; the mean follow-up duration was 2 years. Operative time (mean difference 0.575 hours) and blood loss (mean difference 97.5 ml) were lower in group B. Also, despite the higher frequency of rami displacement before union in the same group, there were no significant differences in terms of radiological outcome (excellent outcome with odds ratio 2.3), clinical outcome (excellent outcome with OR 2.852) & postoperative complications’ assessment (OR 1.556) at last follow-up. Conclusion: Isolated posterior ring fixation is possible in managing Tile B2 & C1 injuries with comparable final radiological and clinical outcomes and similar postoperative complications rate to combined posterior & anterior ring fixation but with less morbidity (shorter operation time and lower amount of blood loss). Level of Evidence: This is considered a level II evidence study (RCT). |