The pelvic external fixation: the mid-term results of 41 patients treated with a newly designed fixator

The purpose of this study was to evaluate the clinical and radiological results of unstable pelvic fractures treated with a new external fixation device. Between May 1992 and May 1998, 43 patients with unstable pelvic fractures were treated with a new anterior pelvic external fixator. Two died, and therefore 41 patients' results were evaluated. There were 29 men and 12 women, and their average age was 34 years (range 12-70 years). Traffic accidents accounted for 34 injuries. Three patients fell from a height, 3 were injured in industrial accidents, and 1 was hit by a train. According to the Tile classification, there were 24 type B pelvic injuries and 17 type C. Associated injuries were observed in 21 patients. A considerable reduction of the pelvic pain was noted after application of the fixator in all patients. Excessive blood transfusion was not required in any patient. The average follow-up was 24 months (range 12-50 months). Clinical results at final evaluation were good according to the criteria of Matta and Saucedo in 34 patients and poor in 7. In conclusion, the new pelvic external fixator is effective, safe, and easy to apply in the treatment of unstable pelvic fractures. The fixator can be used alone in patients with type B pelvic injuries such as open book and lateral compression. However, it does not provide sufficient stability for severely displaced type C injuries when applied alone. Nevertheless, it may be helpful for fixing type C injuries like a posterior iliac fracture without dislocation of the sacroiliac joint.