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Late fixation of vertically unstable type-C pelvic fractures: difficulties and surgical solutions

  • Original Article
  • Published:
European Orthopaedics and Traumatology

An Erratum to this article was published on 19 August 2014

Abstract

Background

Delayed surgical stabilization of unstable pelvic ring disruptions is expected to have difficulties in achieving reduction and fixation with possible higher complications. The aim of this study is to report the difficulties and to evaluate the results of late surgical stabilization of vertically unstable type-C pelvic injuries.

Methods

This study included 16 patients with 20 vertically unstable pelvic fractures who presented 4 weeks or more after the initial trauma during a period of 5 years. Time since injury averaged 7.6 weeks. Age of the patients averaged 28 years. There were 12 unilateral and four bilateral injuries. Seven patients had neurologic injuries. Combined posterior and anterior pelvic ring stabilization was carried out in nine patients, while posterior pelvic ring fixation alone was done in seven. The mean postoperative follow up was 31 months.

Results

All fractures healed with average 14 weeks. Complications included transient L5 palsy, ilio-femoral DVT, and early metal failure. Fracture reduction was considered excellent in 69 %, good in 25 %, and fair in 6 %. Functional outcome according to Majeed score was excellent in 75 %, good in 19 %, and fair in 6 %. There was a high significant positive correlation between time of treatment and fracture reduction (p = 0.009) and a significant correlation between preoperative neurological co-morbidity and functional outcome (p = 0.015). A significant negative correlation was found between functional outcome and fracture type (p = 0.039).

Conclusion

Surgical management of delayed vertically unstable pelvic fractures is recommended to achieve anatomical reduction and rigid fixation and to avoid long-term morbidity.

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Acknowledgments

We thank Dr Dalia G. Mahran (assistant professor of public health and community medicine, Assiut University) for the statistical analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Orthopaedic Department, Assiut University, Assiut, 71111, Egypt

    Osama Farouk, Wael El-Adly & Yaser E. Khalefa

Authors
  1. Osama Farouk
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  2. Wael El-Adly
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  3. Yaser E. Khalefa
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Correspondence to Wael El-Adly.

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Farouk, O., El-Adly, W. & Khalefa, Y.E. Late fixation of vertically unstable type-C pelvic fractures: difficulties and surgical solutions. Eur Orthop Traumatol 6, 15–22 (2015). https://doi.org/10.1007/s12570-014-0266-y

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  • DOI: https://doi.org/10.1007/s12570-014-0266-y

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