Pelvic ring fractures: what about timing?
Keywords:
pelvis, fracture, injury, timing, fixation, surgeryAbstract
Background and aim: Pelvic ring fractures represent a challenge for orthopaedic surgeon. Their management depends on patient’s condition, pattern of fracture and associated injuries. Optimal timing for synthesis is not yet clear. The aim of this study was to define if surgical timing influenced clinic and radiographic outcomes following open reduction and internal fixation for Tile B and C fractures. Materials and methods: 38 patients were included. Patients underwent a clinical examination with the Majeed Score, Iowa Pelvic Score and Orlando Pelvic Score. The radiographic assessment was performed according to Matta Pelvic Score. A statistical analysis of the data compared patients who were operated within 3 weeks (group 1) and those operated later (group 2). Results: Both clinical and radiological outcomes were influenced by timing of surgery. Conclusion: Pelvic ring fractures interest many polytrauma patients and, therefore, their surgical orthopedic approach is frequently delayed as consequence of the severity of the associated clinical conditions. An early surgery of pelvic rong fractures allows a better quality of reduction and osteosynthesis.
References
2. Ragnarsson B, Jacobsson 8. Epidemiology of pelvic ractures in a Swedish county. Acta Orthop. Stand 1992; 63(3): 297-300.
3. Malgaigne J. Traites des fractures et des luxations. Paris: J.B. Balliere, 1847.
4. Mucha P, Fame M. Analysis of pelvic fracture management. J. Trauma 1984; 24(5): 379-86.
5. Schmidt A. Diagnostik, Therapie und Spatfolgen bei Beckenfrakturen. Mschr. Unfallheilk 1974; 77: 73-82.
6. Giannoudis PV. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma . 2007; 63: 875-83.
7. Balogh Z. The epidemiology of pelvic ring fractures a population based study. J Trauma 2007; 63: 1066-73.
8. Wong JM. Fractures of pelvic ring. Injury . 2017; 48: 795-802.
9. Lunsjo K. Associated injuries and not fracture instability predict mortality in pelvic fractures: a prospective study of 100 patients. J Trauma 2007; 62: 687-91.
10. Hauschild O. Mortality in patients with pelvic fractures: results from the German pelvic injury register. J Trauma Acute Care Surg 2008 ;64(2): 449-55.
11. Matta J., Tornetta P, Internal Fixation of unstable Pelvic Ring, Clinical Orthopaedics and Related Research 1996; 329: 129-40.
12. Bosch U, Pohlemann T, Tscherne H: Primary management of pelvic injuries. Orthopade 1992; 21:3 85-92.
13. Browner B, Cole D, Graham M et al: Delayed posterior internal fixation of unstable pelvic fractures. J Trauma 1987; 27: 998-1006.
14. Bucholz R. The pathologic anatomy of Malgaigne fracture-dislocations of the pelvis. J Bone Joint Surg 1981; 63A: 400-4.
15. Failinger M, McGanity P: Current concepts review: Unstable fractures of the pelvic ring. J Bone Joint Surg 1992; 74A: 781-91.
16. Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg [Br] 1989; 71: 304-6.
17. Templeman D, Goulet J, Duwelius PJ, Olson S, Davidson M. Internal fixation of displaced fractures of the sacrum. Clin Orthop Rel Res 1996; 329: 180-5.
18. Cole JD, Blum DA, Ansel LJ. Outcome after fixation of unstable posterior pelvic ring injuries. Clin Orthop Rel Res 1996; 329: 160-79.
19. Matta JM, Mehne DK, Roffi R. Fractures of the acetabulum. Early results ofa prospective study.Clin Orthop Relat Res 1986; 205: 241-50.
20. Pogliacomi F, Costantino C, Pedrini MF, Pourjafar S, De Filippo M, Ceccarelli F. Anterior groin pain in athlete as consequence of bone diseases: aetiopathogenensis, diagnosis and principles of treatment. Medicina dello Sport 2014; 67(1): 1-27.
21. Pogliacomi F, Calderazzi F, Paterlini M, Pompili M, Ceccarelli F. Anterior iliac spines fractures in the adolescent athlete: surgical or conservative treatment? Medicina dello Sport 2013; 66(2): 231-40.
22. Calderazzi F, Nosenzo A, Galavotti C, Menozzi M, Pogliacomi F, Ceccarelli F. Apophyseal avulsion fractures of the pelvis. A review. Acta Biomed 2018; 89(4): 470-6.
23. Papakostidis C, Kanakaris NK, Kontakis G, Giannoudis PV. Pelvic ring disruptions: treatment modalities and analysis of outcomes. Int Orthop 2009; 33: 329-38.
24. Bucknill TM, Blackburne JS. Fracture – dislocations of the sacrum. J Bone Joint Surg 1976; 58-B(4): 467-70.
25. Henderson RC. The long-term results of non-operatively treated major pelvic disruptions. J Orthop Trauma 1989; 3(10): 41-7.
26. McLaren AC, Rorabeck CH, Halpenny J. Long-term pain and disability in relation to residual deformity after displaced pelvic ring fractures. Can J Surg 1990; 33(6): 492-4.
Downloads
Published
Issue
Section
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
