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Pelvic ring disruptions: treatment modalities and analysis of outcomes

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Abstract

A systematic review of the English literature over the last 30 years was conducted in order to investigate the correlation of the clinical outcome of different types of pelvic ring injuries to the method of treatment. Three basic therapeutic approaches were analysed: non-operative treatment (group A), stabilisation of anterior pelvis (group B) and internal fixation of posterior pelvis (group C). Of 818 retrieved reports, 27 case series, with 28 groups of patients and 1,641 patients, met our inclusion criteria. The quality of the literature was evaluated using a structured questionnaire. Outcomes of the eligible studies were summarised by the medians of the reported results. Most of the component studies were of fair or poor quality. Certain radiological results (quality of reduction, malunion rates) were significantly better in group C. From the functional point of view only walking capacity was proved to be significantly better in the groups of operative treatment compared to the non-operative group.

Résumé

Une revue systématique de la littérature anglo-saxonne sur les 30 dernières années a été réalisée de façon à analyser les corrélations concernant le devenir clinique des différents traumatismes du bassin et leurs méthodes de traitement. Trois approches thérapeutiques ont été analysées, les traitements orthopédiques (Groupe A), stabilisation du bassin antérieur (Groupe B) et fixation interne du bassin antérieur (Groupe C). 818 articles analysés, 27 séries représentant 28 groupes de patients (1641 patients) ont été inclus. La qualité de la littérature a été évaluée en utilisant un questionnaire structuré. La plupart des études sont de peu d'intérêt. Certains résultats radiologiques, (qualité de la réduction, pseudarthrose) sont significativement meilleur dans le groupe C. Enfin sur le plan fonctionnel et sur le plan de la récupération de la marche, il existe une différence significative bien meilleure dans les groupes ayant bénéficié d'un traitement chirurgical comparé au groupe traité orthopédiquement.

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Authors and Affiliations

  1. Academic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, UK

    C. Papakostidis, N. K. Kanakaris & P. V. Giannoudis

  2. Academic Department, Trauma and Orthopaedic Surgery, University of Crete, Heraklion, Greece

    G. Kontakis

  3. Academic Department of Trauma and Orthopaedics, Clarendon Wing, Level A, Leeds General Infirmary, Great George Street, Leeds, LS1-3EX, UK

    P. V. Giannoudis

Authors
  1. C. Papakostidis
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  2. N. K. Kanakaris
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  3. G. Kontakis
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  4. P. V. Giannoudis
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Correspondence to P. V. Giannoudis.

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Papakostidis, C., Kanakaris, N.K., Kontakis, G. et al. Pelvic ring disruptions: treatment modalities and analysis of outcomes. International Orthopaedics (SICOT) 33, 329–338 (2009). https://doi.org/10.1007/s00264-008-0555-6

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  • DOI: https://doi.org/10.1007/s00264-008-0555-6

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