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Paper| Volume 23, ISSUE 1, P31-37, 1992

Operative treatment of unstable pelvic fractures

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      Abstract

      Unstable pelvic fractures are serious injuries. Non-operative treatment gives poor early and late results. We report the results of operative treatment of 28 unstable pelvic fractures; eight were rotatory unstable and 20 were both rotatory and vertically unstable. The average age of the patients was 33 years. All the patients underwent operation according to a definite protocol for internal fixation. Mobilization was started within 2 weeks after the operation; the average hospital stay was 9.8 weeks. With an average follow-up of 19 months, there was no mortality. In 20 patients there was no discomfort, five patients had moderate back pain and four patients walked with a limp due to leg length inequality and back pain. Twenty patients returned to gainful employment. Complications included one deep wound infection, two superficial wound infections, one dislodgement of the external fixator, and residual interal rotatory deformity of the hemipelvis. We conclude that opertive treatment of unstable pelvic fractures is safe and that the early and late results are much better than those treated by non-operative means.
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      References

        • Bucholz R.W.
        The pathological anatomy of Malgaigne fracture-dislocations of the pelvis.
        J. Bone Joint Surg. 1981; 63A: 400
        • Goldstein A.
        • Phillips T.
        • Sclafani S.J.A.
        • et al.
        Early open reduction and internal fixation of the disrupted pelvic ring.
        J. Trauma. 1986; 26: 325
        • Henderson R.C.
        The long-term results of nonoperatively treated major pelvic disruptions.
        J. Orthop. Trauma. 1989; 3: 41
        • Hesp W.L.E.M.
        • Van der Werken C.
        • Keunen R.W.M.
        • et al.
        Unstable fractures and dislocations of the pelvic ring — results of treatment in relation to the severity of injury.
        Neth. J. Surg. 1985; 37: 148
        • Holdsworth F.W.
        Dislocation and fracture-dislocation of the pelvis.
        J. Bone Joint Surg. 1948; 30B: 461
        • Huittinen V.M.
        • Slätis P.
        Nerve injury in double vertical pelvic fractures.
        Acta. Chir. Scand. 1972; 138: 571
        • Kellam J.F.
        • McMurtry R.Y.
        • Paley D.
        • et al.
        The unstable pelvic fracture-operative treatment.
        Orthop. Clin. North Am. 1987; 18: 25
        • Looser K.G.
        • Crombie H.D.
        Pelvis fractures: an anatomic guide to severity of injury. Review of 100 cases.
        Am. J. Surg. 1976; 132: 638
        • Matta J.M.
        • Saucedo T.
        Internal fixation of pelvic ring fractures.
        Clin. Orthop. Rel. Res. 1989; 242: 83
        • Monahan P.R.W.
        • Taylor R.G.
        Dislocation and fracture-dislocation of the pelvis.
        Injury. 1975; 6: 325
        • Moreno C.
        • Moore E.E.
        • Rosenberger A.
        • et al.
        Hemorrhage associated with major pelvic fracture: a multispecialty challenge.
        J. Trauma. 1986; 26: 987
        • Naam N.H.
        • Brown W.H.
        • Hurd R.
        • et al.
        Major pelvic fractures.
        Arch. Surg. 1983; 118: 610
        • Raf L.
        Double vertical fractures of the pelvis.
        Acta Chir. Scand. 1966; 131: 298
        • Semba R.T.
        • Yasukawa K.
        • Gustilo R.B.
        Critical analysis of results of 53 Malgaigne fractures of the pelvis.
        J. Trauma. 1983; 23: 535
        • Shaw J.A.
        • Mino D.E.
        • Werner F.W.
        • et al.
        Posterior stabilisation of pelvic fractures by use of the threaded compression rods — case reports and mechanical testing.
        Clin. Orthop. Rel. Res. 1985; 192: 240
        • Simpson L.A.
        • Waddell J.P.
        • Leighton R.K.
        • et al.
        Anterior approach and stabilization of the disrupted sacroiliac joint.
        J. Trauma. 1987; 27: 1332
        • Slätis P.
        • Huittinen V.M.
        Double vertical fractures of the pelvis.
        Acta Chir. Scand. 1972; 138: 799
      1. Tile M. Fractures of the Pelvis and Acetabulum. Williams & Wilkins, Baltimore1984 (etc)
        • Tile M.
        Pelvic ring fractures: should they be fixed?.
        J. Bone Joint Surg. 1988; 70B: 1
        • Tile M.
        • Lifeso R.
        • Dickinson D.
        • et al.
        Disruptions of the pelvic ring.
        Orthop. Trans. 1982; 6: 324