Operative treatment of unstable pelvic fractures

Unstable pelvic fractures are serious injuries. Non-operative treatment gives poor early and late results. We report the results of operative treatment of 28 unstable pelvic fractures; eight were rotatory unstable and 20 were both rotatory and vertically unstable. The average age of the patients was 33 years. All the patients underwent operation according to a definite protocol for internal fixation. Mobilization was started within 2 weeks after the operation; the average hospital stay was 9.8 weeks. With an average follow-up of 19 months, there was no mortality. In 20 patients there was no discomfort, five patients had moderate back pain and four patients walked with a limp due to leg length inequality and back pain. Twenty patients returned to gainful employment. Complications included one deep wound infection, two superficial wound infections, one dislodgement of the external fixator, and residual interval rotatory deformity of the hemipelvis. We conclude that operative treatment of unstable pelvic fractures is safe and that the early and late results are much better than those treated by non-operative means.