Experiences and lessons learned from treatment of unstable pelvic fractures
10.3760/cma.j.issn.1001-8050.2011.04.003
- VernacularTitle:不稳定骨盆骨折的救治经验和教训
- Author:
Juan WANG
;
Qi ZHANG
;
Wei CHEN
;
Bo WANG
;
Guohui XU
;
Yingze ZHANG
- Publication Type:Journal Article
- Keywords:
Pelvis;
Fracture fixation;
Iatrogenic disease/prevention and control
- From:
Chinese Journal of Trauma
2011;27(4):296-299
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the clinical treatment of the unstable pelvic fractures. Methods A retrospective study was conducted based on the clinical data of 32 patients with unstable pelvic fractures who were admitted to the Third Hospital of Hebei Medical University from June 2008 to June 2010.There were 20 patients with type B injury and 12 with type C injury according to AO classification scheme.Of all, four patients were treated conservatively, one was treated with emergency external fixation followed by angiographic management, and the remaining 27 patients received selective surgeries. The surgeries were carried out at days 4-43 after trauma by using the external fixators in seven patients, the plates in nine, the iliosacral screws in four, the plate plus external fixator in four, the iliosacral screw plus external fixator in two and the iliosacral screw plus plate in one, respectively. Results The follow-up for an average 15 months among 30 patients showed bony union in 27 patients, malunion in two and nonunion in one. The clinical outcomes of 29 patients was assessed with the Majeed' s scoring system, which showed excellent result in 26 patients, good in nine and poor in three, with excellence rate of 90%. Secondary injuries caused by unstable fractures occurred in two patients and iatrogenic injuries caused by fracture reduction in two.Conclusions Unstable pelvic fractures should be treated surgically as early as possible to restore the stability of the full pelvic ring and prevent the secondary injury, while the conservative treatment is unreliable.Attentions should be paid to avoidance iatrogenic injuries, especially nerve injuries, during the course of treatment.
