[Results of external fixation in pelvic ring fractures]

Pelvic ring fractures are severe injures, with high mortality and morbidity rates. In the past orthopedic treatment was preferred, but after 1960 external fixation started to be used in the treatment of these fractures. External fixation is preferred in fractures with moderate displacement and incomplete posterior injuries of pelvic ring. There are lots of types of external fixators: uniplane--easy to apply, but unstable; multiplane--with complex geometry witch offers a more solid fixation, but needs a more complex technique to be applied.

We studied a series of 24 cases of unstable pelvic ring injuries in a four year period. Primarily, the injuries were classified as follows: 21 type B and 3 type C.

All patients were treated with external fixation. Good clinical and radiological results were noted in 20 cases. The main intraoperative complications were the impossibility to insert all the Schanz screw between the two cortices of the iliac wing (6 cases) and insufficient reduction (4 cases). Postoperative complications were seen in 7 patients: pin tract infections (2 cases), secondary displacement or insufficient reduction (4 cases), screw fixation loosening (1 case).

Treatment of type B of the pelvic ring with external fixation is a highly effective yet relatively simple and minimally invasive treatment method. Surgical time and blood loss are minimal, and patients can be effectively and rapidly mobilized. Clinical outcome is often unsatisfying because the posterior pelvic ring fracture is underdiagnosed and this type of fixation is sometimes used in patients with type C fractures.