Pelvic ring disruptions: treatment modalities and analysis of outcomes

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.