Abstract:Objective To compare anterior pelvic external fixation (APEF) and internal anterior fixation (INFIX) in the treatment of anterior ring pelvic fractures.Methods From January 2015 to January 2019,a consecutive series of 61 patients who underwent surgical stabilization of anterior ring pelvic at our department were studied.They were divided into two groups according to their fixation of the anterior pelvic ring.30 cases were treatedwith APEF.There were 17 males and 13 females.The average was (46.2±2.2)years(range,36 to 58 years).According to Tile,s classification,14 of them were type B,16 were type C.31 cases were treated withINFIX,there were 14 males and 17 females.The average age was (47.1±2.4)years (range 37 to 60 years).According to Tile,s classification,13 of them belonged to type B and 18 to type C.Data of surgical or postoperative complications was collected,including iatrogenic nerve injury,infection,implant failure and radiographic union.The quality of fracture reduction of the two groups was evaluated by Matta standard,and the recovery of limb function was evaluated by Majeed scoring system.Finally,statistical analysis was performed to evaluate significant differences between two groups.Results The patients were followed up foran average of (14.2±2.3)months (range,12 to 18 months).According to Matta criteria for fracture reduction,10 cases were excellent,16 good,3 fair and one poor case in the APEF,(excellent and good rate:86.7%).In the INFIX group,there were 9 cases excellent,18 good,2 fair,2 poor (excellent and good rate:87.1%).There was no significant difference between the two groups (P>0.05).There were 15 cases excellent,10 good,5 fair of the pelvic function assessed by the Majeed scoring system at the final follow-up in the APEF (excellent and good rate:83.3%),and 16 cases excellent,12 good,3 fair in the INFIX (excellent and good rate:90.3%).The difference was statistically significant between the 2 groups (P<0.05).At the 3 months follow-up,there were no bone nonunion.In the APEF group,3 cases (10%) were suffered from lateral femoral cutaneous nerve injury,5(16.7%) had screw loosening and 4 (13.3%)had pin tract infection.In INFIX group,4 cases (12.9%) had lateral femoral cutaneous nerve injuries,one (3.2%) had skin infection,there were no screw loosening.There was no significant difference in lateral femoral cutaneous nerve injury between the two groups (P>0.05),but there were statistically significant differences in screw loosening and pin infection between the APEF group and the INFIX group (P<0.05).Conclusion APEF and INFIX can improve the pelvic stability,but INFIX can achieve better clinical outcomes and fewer operative complications in the treatment of anterior pelvic ring fractures.