J Korean Fract Soc.  2012 Oct;25(4):243-249. 10.12671/jkfs.2012.25.4.243.

Operative Treatment of Unstable Pelvic Ring Injury

• Lee SH
• Ha SH
• Lee YK
• Cho SW
• Park SS

• KMID: 1434061
• DOI: http://doi.org/10.12671/jkfs.2012.25.4.243

Abstract

PURPOSE
To analyze the clinical and radiological results of the different fixation methods according to the type and displacement of unstable pelvic ring injuries.
MATERIALS AND METHODS
Twenty-three patients with unstable pelvic ring injuries from January 2005 to December 2009 were classified according to the AO/OTA classification system. When patients had been diagnosed with unstable pelvic ring injuries with partial instability, they were treated by anterior fixation with a plate and posterior percutaneous iliosacral screw fixation. When patients had been diagnosed with unstable pelvic ring injuries with complete instability, they were treated by open reduction and anterior to posterior fixation with a plate through the ilioinguinal approach. The radiological results were evaluated using Matta and Saucedo's method, and the clinical results were evaluated using Rommens and Hessmann's method.
RESULTS
The outcomes from the radiological evaluation were that the displacement of the posterior pelvic ring were improved by about 6.65 mm in unstable pelvic ring injuries with partial instability. The displacement of the posterior pelvic ring were improved by about 7.8 mm in unstable pelvic ring injuries with complete instability. The clinical results were excellent in 13 cases and good in 6 cases on latest follow-up.
CONCLUSION
Good results can be achieved by selecting the treatment method according to the type of unstable pelvic ring injurie and displacement.

Keyword

Unstable pelvic ring injury; Plate; Percutaneous iliosacral screw

MeSH Terms

Displacement (Psychology)
Humans

Figure

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  Fig. 1 (A, B) A 41-year-old male patient who had an unstable pelvic fracture with symphysis pubis diastasis and sacroiliac joint disruption. (C, D) Plate fixation on symphysis pubis and percutaneous iliosacral screw fixation on sacroiliac joint. (E) After 30 months, he had a complete union and excellent function.

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  Fig. 2 (A, B) A 65-year-old female patient who had unstable pelvic fracture with superior and inferior ramus fracture and sacroiliac joint disruption. (C, D) Through the anterior approach, anatomical reconstruction was achieved with the fixation of the anterior and posterior rings. (E) After 53 months, she had a complete union and excellent function.

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