scholarly journals Surgical treatment of unstable pelvic ring fractures

2019 ◽  
Vol 76 (1) ◽  
pp. 36-41
Author(s):  
Miroslav Kezunovic ◽  
Nikola Bulatovic
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Internal Fixation ◽  
External Fixation ◽  
Pelvic Ring ◽  
Early Mobilization ◽  
Skeletal Traction ◽  
Pelvic Ring Injuries ◽  
Pelvic Ring Fractures ◽  
Stable Osteosynthesis

Background/Aim. Pelvic ring fractures are complex injuries and are often associated with internal organs injuries. These injuries require rapid and accurate diagnosis and in some cases one or more surgical interventions. The aim of this retrospective study is to describe the indications and outcomes of surgical treatment of pelvic ring injuries with the emphasis on anatomical reconstruction and stable osteosynthesis as a prerequisite for early mobilization and more favorable functional outcomes. Methods. In the period from 2006 to 2012, fifty-five patients with pelvic ring injuries with or without acetabular fractures were analyzed. The average age of all patients was 36 years. Forty-one patients were treated with operational open reduction and internal fixation (ORIF) while nine of them were treated nonoperatively (bed rest, skeletal traction and external fixation). Results. All operated patients were treated within 3- 24 days with ORIF, stable osteosynthesis and early mobilization which resulted in avascular necrosis (AVN) of the femoral head in two cases. AVN of the femoral head was noted in five cases in combined and isolated pelvic ring injuries and acetabulum which were treated with skeletal traction. Neurological deficit was recorded in three patients treated with conservative methods while two patients underwent ORIF. Deep vein thrombosis (DVT) was noted in two patients and pulmonary thromboembolism appeared in one patient 23 days after surgical intervention. Two infections occurred around Steinman pins in the patients who had the definitive treatment performed with external fixator. In one patient treated with ORIF a superficial infection occurred and was treated with antibiotics. The functional results were evaluated based on Merle d'Aubign? score. The results of the radiography treatment were analyzed according to Slatis. Conclusion. Strict application of rational criteria and surgical technique with stable internal fixation with early mobilization provide significantly better outcomes of these injuries in relation to non surgical treatment or treatment with definitive external fixation.

scholarly journals Surgical treatment of the unstable type C pelvic injury

2013 ◽  
Vol 60 (2) ◽  
pp. 53-58 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Jordan Saveski ◽  
Ivan Micic ◽  
Milan Mitkovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Open Reduction ◽  
Pelvic Ring ◽  
Posterior Pelvic Ring ◽  
Pelvic Ring Injuries ◽  
Pelvic Injuries ◽  
Ring Complex ◽  
Type C ◽  
Stable Internal Fixation

Rotationally and vertically unstable injuries to the pelvic ring (Type C) require stabilisation of the anterior and posterior pelvic ring complex. Inadequate treatment of these injuries leads to chronic instability of the pelvic ring, which can finally cause permanent disability. Open reduction and stable internal fixation of the anterior and posterior complex of unstable pelvic ring injuries are standard procedures in the treatment of hemodynamically stable patients with (Type C) pelvic injuries. Our aim is to show that this type of treatment achieves excellent and good results. All patients were operated on using the method of open reduction and anterior plate fixation of sacroiliac complex as well as fixation of the pubic symphisis. We present a retrospective study of the results concerning the treatment of 19 patients with (Type C ) unstable pelvic injuries. The average age of the patients was 43,21 years old. The final functional results, 2 years post-surgery according to the Majeed scoring system and the results were excellent in 11 (57.89%) and good in 8 (42.1%) patients. There were no bad results to report. Type C pelvic ring injuries are unstable and unless they are adequately treated, they can lead to permanent consequences. Surgical treatment that includes open reduction and stable internal fixation of the anterior and posterior pelvic ring complex leads to excellent and good results. The patients that were treated surgically by fixation of the anterior and posterior pelvic ring complex return to their everyday lives and work activities.

Surgical Treatment for Unstable Pelvic Ring Injuries

2013 ◽  
Vol 20 (4) ◽  
pp. 9-16
Author(s):  
S. V Donchenko ◽  
V. E Dubrov ◽  
L. Yu Slinyakov ◽  
A. V Chernyaev ◽  
A. F Lebedev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
External Fixation ◽  
Pelvic Ring ◽  
Damage Control ◽  
Main Group ◽  
Control Group ◽  
Concomitant Injuries ◽  
Surgical Interventions ◽  
Pelvic Ring Injuries ◽  
Unstable Pelvic Ring Injuries

Treatment results for 67 patients (43 men, 24 women), aged 15–70 years, with unstable pelvic ring injuries are presented. In 15 cases conservative treatment (control group) and in 52 cases various surgical interventions (main group) were performed. In the main group of patients a strategy of two5step surgical treatment of the victims with multiple and concomitant injuries Damage control concept was applied. It included urgent stabilization of pelvic ring with external fixation devices and C-frame, bleeding arrest, final fixation within first 5–7 days after stabilization of patient’s condition. Restoration of the anterior semi5ring was performed using either external fixation device or a reconstructive plate. Stabilization of sacroiliac junction was per5 formed with cannulated screws. All patients were allowed to walk on crutches within 1–5 days after operation. In control and main groups the duration of hospitalization made up 43.7±2.5 and 25.7±3.1 days (p

Functional Outcome of Open Reduction and Internal Fixation for Completely Unstable Pelvic Ring Fractures (Type C)

2003 ◽  
Vol 17 (8) ◽  
pp. 555-562 ◽  
Author(s):  
Sevki Kabak ◽  
Mehmet Halici ◽  
Mehmet Tuncel ◽  
Levent Avsarogullar ◽  
Ali Baktir ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Pelvic Ring ◽  
Pelvic Ring Fractures ◽  
Type C

scholarly journals Surgical treatment of pertrochanteric fractures by dynamic methods of external and internal fixation

2003 ◽  
Vol 60 (6) ◽  
pp. 663-667 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Mile Radenkovic ◽  
Desimir Mladenovic ◽  
Gordana Soldatovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
External Fixation ◽  
Functional Results ◽  
Surgical Trauma ◽  
Pertrochanteric Fractures ◽  
Skeletal Mass ◽  
Dynamic Methods ◽  
Life Threat ◽  
Methods Of Treatment

Pertrochanteric fractures usually occur in patients over 65 years of age, with greater loss of skeletal mass (osteoporosis). Nonsurgical methods of treatment are accompanied by relatively high lethality rate. Moreover, they do not produce satisfactory anatomical and functional results. Surgical treatment by using dynamic implants represents a method of choice in the fixation of pertrochanteric fractures. This paper presents the treatment results of 110 patients, 61 with pertrochanteric fractures, who were surgically treated by the dynamic method of internal fixation, and 49 patients who were treated by the method of external fixation. Dynamical implants enabled both dynamization and compression of the fracture in the axis of the neck, as well as the diaphysis of the femur, which lowered the risk of mechanical complications, and, at the same time, provided effective healing of the fracture, early activation, and mobilization of the patients on whom the surgery was performed. In patients infected by various diseases, for whom surgical trauma represents a life threat, the external fixation is recommended as a method of choice.

scholarly journals Robot-assisted Minimally-invasive Internal Fixation of Pelvic Ring Injuries: A Single-center Experience

2019 ◽  
Vol 11 (1) ◽  
pp. 42-51
Author(s):  
Hua-shui Liu ◽  
Sheng-jun Duan ◽  
Fu-zhen Xin ◽  
Zhen Zhang ◽  
Xue-guang Wang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Pelvic Ring ◽  
Single Center ◽  
Robot Assisted ◽  
Pelvic Ring Injuries ◽  
Single Center Experience ◽  
Minimally Invasive Internal Fixation

External fixation of unstable pelvic ring fractures: comparative rigidity of some current frame configurations

1982 ◽  
Vol 20 (6) ◽  
pp. 727-733 ◽  
Author(s):  
T. D. Brown ◽  
J. Patterson Stone ◽  
J. H. Schuster ◽  
D. C. Mears
Keyword(s):  
External Fixation ◽  
Pelvic Ring ◽  
Current Frame ◽  
Pelvic Ring Fractures

Elevated Body Mass Index Increases Early Complications of Surgical Treatment of Pelvic Ring Injuries

2010 ◽  
Vol 24 (5) ◽  
pp. 309-314 ◽  
Author(s):  
S Andrew Sems ◽  
Michael Johnson ◽  
Peter A Cole ◽  
Catherine T Byrd ◽  
David C Templeman
Keyword(s):  
Body Mass Index ◽  
Surgical Treatment ◽  
Body Mass ◽  
Pelvic Ring ◽  
Early Complications ◽  
Pelvic Ring Injuries ◽  
Elevated Body Mass Index

Pelvic Fractures

1994 ◽  
Vol 35 (5) ◽  
pp. 420-425 ◽  
Author(s):  
J. Albrechtsen ◽  
J. Hede ◽  
A. G. Jurik
Keyword(s):  
Femoral Head ◽  
Pelvic Ring ◽  
Posterior Part ◽  
Conventional Radiography ◽  
Pelvic Fractures ◽  
Acetabular Fractures ◽  
Pelvic Ring Fractures

Sixty-two patients with pelvic fractures were evaluated by conventional radiography and CT. A correct pathoanatomic classification of the fractures was most often obtained by conventional radiography, but CT added information regarding acetabular fractures and involvement of the posterior part of the pelvic ring. Besides, CT was essential in the detection of intraarticular fragments and lesions of the femoral head. Classification of pelvic ring fractures by the pattern of traumatic forces was easily obtainable by conventional radiography, but often difficult to achieve by CT.

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