Open reduction internal fixation of a pelvic malunion through an anterior approach

Whereas the initial treatment of pelvic fractures and their long-term outcomes have been well researched, little has been written concerning the surgical management of late pelvic malunions and nonunions causing residual pain and deformity. The available literature describes osteotomies usually done in multiple stages. The authors report the case of a progressive lateral compression pelvic disability treated in a unique one-stage procedure. This one-stage anterior approach allowed excellent correction of the deformity. In cases in which the deformity is purely one of internal or external rotation or medial or lateral displacement with no vertical migration, the authors think it is possible to adequately mobilize the pelvis to an anatomic reduction in a single-stage anterior approach. In cases in which vertical migration of the hemipelvis causes symptoms, it is probably necessary to approach the patient posteriorly to safely mobilize and adequately reduce the hemipelvis. With these factors in mind, the authors think a one-stage anterior approach can be an effective treatment for appropriately selected pelvic malunions.