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Case Reports in Orthopedics
Volume 2016 (2016), Article ID 9468285, 7 pages
http://dx.doi.org/10.1155/2016/9468285
Case Report

INFIX/EXFIX: Massive Open Pelvic Injuries and Review of the Literature

1Detroit Medical Center, 4D University Health Center, Detroit Receiving Hospital, 4201 Street Antoine Boulevard, Detroit, MI 48201, USA
24D University Health Center, Detroit Receiving Hospital, Wayne State University, 4201 Street Antoine Boulevard, Detroit, MI 48201, USA

Received 1 May 2016; Accepted 16 June 2016

Academic Editor: Arul Ramasamy

Copyright © 2016 Rahul Vaidya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Open pelvic fractures make up 2–5% of all pelvic ring injuries. Their mortality has been reported to be as high as 50%. During Operation Enduring Freedom protocols for massive open pelvic injuries lead to the survival of injuries once thought to be fatal. The INFIX is a subcutaneous anterior fixator for pelvic stabilization which is stronger than external fixation. The purpose of this paper is to describe the use of INFIX and modern algorithms for massive open pelvic injuries. Methods. An IRB approved retrospective review describes 4 cases in civilian practice with massive open pelvic injuries. We also review the modern literature on open pelvic injures. Discussion. Key components in the care of massive open pelvic injuries include hemorrhage control by clamping of the aorta or REBOA when necessary and fecal/urinary diversion. The INFIX can be used internally, as a partial INFIX partial EXFIX, or as an EXFIX. Its low profile allows for easy application of wound vacs and wound care and when subcutaneous avoids pin tract infections. Conclusion. Massive open pelvic injuries are a difficult problem. Following modern protocols can help prevent mortality.