For elderly with fragility fractures of the pelvis (FFP) type III, minimally invasive surgery may reduce perioperative morbidity and facilitate mobilization, but evidence guiding implant selection remains limited. We evaluated postoperative hip function, recovery of independence in activities of daily living, and safety of the anterior subcutaneous pelvic internal fixator (INFIX) in elderly patients with FFP type III fractures, including surgery-related complications and fixation failure. We retrospectively reviewed all elderly patients (≥ 65 years) with FFP type III fractures treated with INFIX between 2020 and 2023. Data collected included demographics, comorbidities, general and surgery-related complications, length of hospital stay, visual analogue scale (VAS), Majeed score, Barthel Index, and mortality. Minimum follow-up was 12 months. Forty-seven patients were included, with a mean follow-up of 28.2 ± 13.1 months. The mean Majeed score was 82.9 ± 10.1. 91.5% (n = 43) achieved a cumulative walking distance > 1,000 m at follow-up. The mean Barthel Index was 84.3 ± 8.9. Surgery-related complications included lateral femoral cutaneous nerve irritation/injury in 21.3% (n = 10), wound infection in 6.4% (n = 3), and heterotopic ossification in 10.6% (n = 5). Screw loosening occurred in 12.8% (n = 6) but did not require reoperation. INFIX for elderly patients with FFP type III fractures was associated with acceptable functional outcomes despite a relatively high rate of surgery-related complications, and most patients regained independence in activities of daily living during follow-up. Therefore, for Type III FFP, the INFIX technique maybe a viable option.
Yang et al. (Tue,) studied this question.