External fixation for pelvic ring disruptions anatomical and functional outcomes

ABSTRACT

Unstable pelvic ring disruptions are often associated with significant morbidity and mortality specially in patients with multiple injuries . stabilization of the pelvic ring by external fixator helps to control haemorrhage and allows comfortable mobility of the patient. Thirty five patients were treated by pelvic external fixator for their unstable pelvic injuries, but the analysis of the results included only 26 cases .Open technique for pin placement was used in seventeen cases, while the closed technique was used in nine cases. The fixator pins were inserted into the iliac crest between the iliac cortical tables to a depth of 5 cm . All patients had closed manipulative reduction of the pelvic ring under image control. The average hospitalization period was 16 days for the patients with isolated pelvic injuries. The average hospitalization for all patients was 37 days .Evalualution of the anatomical results depended on the diastasis of the symphysis pubis and proximal migration of the hemipelvis. The satisfactory anatomical results were 57.4% .The functional results were assessed by a numerical scoring system [Majeed 1989] . The satisfactory functional results were 65.38%. The complications were mainly related to the pins of the fixator . These complications were lower for the pins inserted by closed technique . There were two cases of delayed union due to imperfect reduction. External fixation for pelvic ring disruption is a safe simple method .It is suitable for all cases of pelvic ring injuries those are rotationally unstable but vertically stable