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13-Year experience in external fixation of the pelvis: complications, reduction and removal

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the complications associated with anterior pelvic external fixation and the success of this device in maintaining reduction when used in conjunction with sacroiliac screws.

Methods

Through a retrospective clinical study at an academic Level I Trauma Center, 129 patients fit the criteria for inclusion with a mean duration of anterior pelvic external fixation of 62 days and mean follow-up of 360 days. Charts were reviewed for complications postoperatively. The symphysis diastasis, vertical displacement and posterior displacement of each hemipelvis were quantified from pelvic radiographs.

Results

Of the 129 patients receiving anterior pelvic external fixation, 14 (10.9 %) presented to an emergency department for problems with their anterior pelvic external fixation. Of these 14 patients, 7 (5.4 %) required readmission, all for infectious concerns necessitating IV antibiotics. 6 (4.7 %) required formal operative debridement and device removal. 13 patients (10.1 %) had superficial pin site infections successfully treated with oral antibiotics. Reduction was maintained (rated as fair, good or excellent) in all patients with radiographic follow-up (n = 74, average radiographic follow-up of 216 days) following removal of their anterior pelvic external fixation. 38 patients (30.4 %) had their anterior pelvic external fixation removed in clinic, while 87 (69.6 %) had formal removal in the operating room.

Conclusion

While previous data suggest high complication rates in definitive anterior pelvic external fixation, we present the largest cohort of patients receiving anterior pelvic external fixation and sacroiliac screws, demonstrating a low complication rate while maintaining reduction of the pelvic ring. In addition, we found that these devices could be reliably removed in a clinic setting.

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Acknowledgments

No financial support was received for this study.

Conflict of interest

Author W. Obremskey has previously consulted for biometrics; done expert testimony in legal matters, has a grant from the Department of Defense, and has been a Board Member of the OTA and SEFC. For the remaining authors P. M. Mitchell, C. M. Corrigan, N. A. Patel, A. J. Silverberg, S. E. Greenberg, R. V. Thakore, J. M. Ehrenfeld, J. M. Evans and M. K. Sethi no conflicts of interest were declared.

Copyrighted material/consent forms

This study used no previously copyrighted materials or signed patient consent forms.

IRB approval

This study has approval from the Vanderbilt IRB.

Compliance with ethics guidelines

All human and animal studies have been approved by the appropriate ethics committee and have, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Authors and Affiliations

  1. The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA

    P. M. Mitchell, C. M. Corrigan, N. A. Patel, A. J. Silverberg, S. E. Greenberg, R. V. Thakore, W. T. Obremskey, J. M. Ehrenfeld, J. M. Evans & M. K. Sethi

Authors
  1. P. M. Mitchell
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  2. C. M. Corrigan
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  3. N. A. Patel
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  4. A. J. Silverberg
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  5. S. E. Greenberg
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  6. R. V. Thakore
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  7. W. T. Obremskey
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  8. J. M. Ehrenfeld
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  9. J. M. Evans
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  10. M. K. Sethi
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Corresponding author

Correspondence to M. K. Sethi.

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Mitchell, P.M., Corrigan, C.M., Patel, N.A. et al. 13-Year experience in external fixation of the pelvis: complications, reduction and removal. Eur J Trauma Emerg Surg 42, 91–96 (2016). https://doi.org/10.1007/s00068-015-0499-7

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  • DOI: https://doi.org/10.1007/s00068-015-0499-7

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