Yang XD, Lu YT, Lai Z, Wang JJ, Jiang HC, Gu C, Fan SC. Clinical efficacy and psychological influence of lateral rectus approach for treating pelvic fracture with lumbosacral plexus injury. World J Psychiatry 2025; 15(5): 101844 [DOI: 10.5498/wjp.v15.i5.101844]
Corresponding Author of This Article
Shi-Cai Fan, Department of Traumatic Surgery, The Third Affiliated Hospital of Southern Medical University, No. 183 Zhongshan Avenue West, Tianhe District, Guangzhou 510600, Guangdong Province, China. ylz20200227@163.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiao-Dong Yang, Zhen Lai, Huan-Chang Jiang, Cheng Gu, Department of Orthopaedic, Huadu District People’s Hospital of Guangzhou, Guangzhou 510800, Guangdong Province, China
Xiao-Dong Yang, Shi-Cai Fan, Department of Traumatic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510800, Guangdong Province, China
Yu-Ting Lu, Department of Dermatology, Huadu District People’s Hospital of Guangzhou, Guangzhou 510800, Guangdong Province, China
Jun-Jie Wang, Department of Psychology, Huadu District People’s Hospital of Guangzhou, Guangzhou 510800, Guangdong Province, China
Co-first authors: Xiao-Dong Yang and Yu-Ting Lu.
Author contributions: Yang XD and Lu YT contribute equally to this study as co-first authors; Yang XD and Lu YT participated in the conception and design of the study and were involved in the acquisition, analysis, or interpretation of data; Yang XD and Lu YT wrote the manuscript; Lai Z, Jiang HC, Gu C, Fan SC, Wang JJ accessed and verified the study data; all authors critically reviewed and provided final approval of the manuscript; all authors were responsible for the decision to submit the manuscript for publication.
Supported by National Key Research and Development Plan, No. 2022YFC2504303; National Natural Science Foundation of China, No. 82072411; Guangzhou Area Clinical High-tech and Major Technology Projects, No. 2024PL-GX11; Internal Medicine Research Fund Project of Huadu District People's Hospital, Guangzhou (Excellent Youth Project), No. 2020B06.
Institutional review board statement: The study was reviewed and approved by The Third Affiliated Hospital of Southern Medical University.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at YLZ20200227@163.com. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Cai Fan, Department of Traumatic Surgery, The Third Affiliated Hospital of Southern Medical University, No. 183 Zhongshan Avenue West, Tianhe District, Guangzhou 510600, Guangdong Province, China. ylz20200227@163.com
Received: November 28, 2024 Revised: December 31, 2024 Accepted: March 31, 2025 Published online: May 19, 2025 Processing time: 153 Days and 2.2 Hours
Abstract
BACKGROUND
The surgical treatment of pelvic fractures is challenging, particularly after lumbosacral plexus injuries. Such impairments affect a patient's physiological function and can cause significant mental health problems. In recent years, the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients' physiological and psychological conditions. Therefore, investigating its clinical efficacy for treating pelvic fractures plus lumbosacral plexus injuries is of great clinical significance.
AIM
To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.
METHODS
Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach (January 2011 to May 2024) were retrospectively analyzed. The patients' general data were collected via questionnaire. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess anxiety and depression, respectively. We adopted a numerical rating scale (NRS) to evaluate pain degree, the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, and Medical Research Council (MRC) Scale for Muscle Strength to evaluate treatment efficacy and complications.
RESULTS
The 136 included patients (92 male, 44 female) were a mean 48.02 ± 15.72 years old. The mean SAS score was 66.36 ± 5.15 preoperatively vs 42.15 ± 4.36 postoperatively, while the mean SDS score was 65.61 ± 5.02 preoperatively vs 43.83 ± 4.54 postoperatively, showing statistically significant differences (P < 0.05). The mean NRS and PSQI scores were significantly lower pre- vs postoperatively (P < 0.05). Postoperatively, 67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5, 22 achieved an M1-M4, and four achieved an M0. Postoperative motor function improved by a mean 4.20 grades (scale, 0-5). Among the patients with old pelvic fractures and nerve injuries, 19 achieved an M5, 16 achieved an M1-M4, and eight achieved an M0. Motor function improved significantly by a mean 3.30 grades (scale, 0-5; P < 0.05). No serious postoperative complications occurred.
CONCLUSION
The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression, relieve pain, improve sleep quality, reduce intraoperative blood loss, and improve postoperative recovery.
Core Tip: To investigate the clinical effect of the transrectus lateral approach in the treatment of pelvic fractures complicated by lumbosacral plexus injuries as well as its influence on anxiety and depression. We conclude that the transrectus lateral approach for the treatment of pelvic fractures complicated by lumbosacral plexus injuries can alleviate anxiety and depression, relieve pain, improve sleep quality, reduce intraoperative blood loss, improve postoperative recovery, and provide high safety.
