Clin Orthop Surg.  2015 Sep;7(3):396-401. 10.4055/cios.2015.7.3.396.

Surgical Correction of Pelvic Malunion and Nonunion

• Lee KJ
• Min BW
• Oh GM
• Lee SW

• KMID: 2234097
• DOI: http://doi.org/10.4055/cios.2015.7.3.396

Abstract

Regardless of the method of treatment, as many as 5% of all pelvic fractures result in malunion or nonunion of the pelvis. However, there is not much information in the literature on the management of these late complications. Because they cause disabling symptoms and socioeconomic problems, some patients with malunion or nonunion of pelvic fractures need to undergo surgery. We report our experience with satisfactory results of surgery for pelvic malunion and nonunion in four patients. The key to successful reconstruction is thorough preoperative planning and methodical surgical intervention.

Keyword

Pelvis; Fractures; Malunited; Ununited

MeSH Terms

Adult
Female
Fracture Fixation, Internal/*instrumentation/*methods
Fractures, Malunited/radiography/*surgery
Fractures, Ununited/radiography/*surgery
Humans
Pelvic Bones/injuries/radiography/*surgery

Figure

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  Fig. 1 Case 1. (A) Initial anteroposterior view. (B) The three-dimensional computed tomography image shows upward migration and internal rotation deformity of the left hemipelvis. (C) The radiograph obtained immediately after surgery shows correction of the deformity. (D) The radiograph obtained 4 years after surgery shows union and maintenance of the reduction.

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  Fig. 2 Case 2. (A) The initial outlet view shows cranial displacement. LLD: leg-length discrepancy. (B) The three-dimensional computed tomography outlet view shows upward migration and medial translation deformity of the right hemipelvis. (C) The outlet view radiograph obtained immediately after surgery, shows correction of superior migration. (D) The radiograph obtained 2.7 years after surgery shows a well-maintained reduction.

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  Fig. 3 Case 3. (A) The initial inlet view radiograph shows severe residual internal rotation deformity of the right hemipelvis. (B) The radiograph obtained immediately after surgery shows correction of the internal rotation. (C) The radiograph obtained 2 months after surgery shows loss of reduction, metal failure, and nonunion. (D) In revision surgery, the anterior lesion was reopened and fixed with a broad plate.

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  Fig. 4 Case 4. (A) Initial anteroposterior radiograph. (B) The three-dimensional computed tomography image shows nonunion through the right sacrum and the left pubic rami, with displacement. (C) The postoperative anteroposterior view shows correction of the deformity. (D) The radiograph obtained 14 months after surgery shows a well-maintained reduction.

Reference

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