Abstract
We present the clinical and radiological outcome of a 13-year cohort study of 38 open
book pelvic lesions. All patients were treated in one Level I Trauma centre. In the
posterior pelvis, sacro-iliac diastasis was seen in 31 patients, sacral fracture in
7. In all patients with sacro-iliac diastasis, the pubic bone was inferiorly displaced
on the primary ap pelvic overview on the side of injury. All but one patient was treated
with open reduction and internal fixation of the symphysis pubis. Additional stabilization
of the posterior pelvis was done in 9 patients. 32 patients were seen after a median
follow up of 84 months. Majeed score and SF-36 questionnaire were used. Functional
outcome was excellent with a mean Majeed score of 95.7. Comparing our data with the
SF-36 score of the normal German population, the mean value of the ‘role-physical’
and the ‘physical function’ categories was significantly lower for patients treated
with an open book lesion. There was a tendency towards a better outcome in open book
lesions with sacral fracture. There was a tendency towards worse outcome for the patients
with additional dorsal stabilization. Male impotence was the single most important
lesion of neurological origin which persisted two years after open book lesion.
Conclusion
Functional outcome after surgical treatment of open book pelvic lesions is good. External
rotation and accompanying inferior displacement of the ipsilateral hemipelvis may
be a sign of partial lesion of the posterior sacroiliac complex. Identification of
patients who need additional posterior stabilization remains difficult.
Keywords
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Article info
Publication history
Accepted:
November 17,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
