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TREATMENT OF PUBIC DISJUNCTION IN YOUNG-BURGUESS TYPE II AND III PELVIC RING FRACTURES.

R I Malancea, R Malancea, B Veliceasa

    Revista Medico-Chirurgicala a Societatii De Medici Si Naturalisti Din Iasi
    |April 30, 2016
    PubMed
    Summary

    External fixation is a viable treatment for pelvic ring fractures in patients unable to tolerate extensive surgery. While pubic diastasis may persist, it often remains asymptomatic, with good clinical outcomes reported.

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    Area of Science:

    • Orthopedic Surgery
    • Trauma Management
    • Pelvic Fractures

    Background:

    • Pelvic ring fractures, specifically Young-Burgess types II and III, present complex treatment challenges.
    • Pubic disjunction is a common component requiring careful management.
    • Assessing treatment outcomes for these fractures is crucial for patient recovery.

    Purpose of the Study:

    • To evaluate the personal experience and outcomes of treating pubic disjunction in Young-Burgess type II and III pelvic ring fractures.
    • To compare the effectiveness of different fixation methods for pubic disjunction.

    Main Methods:

    • A study included 30 patients (age 32-76) with Young-Burgess type II and III pelvic ring fractures.
    • 18 patients received external fixation; 12 underwent surgical treatment (ORIF for type II, ORIF with posterior fixation for type III).
    • Mean follow-up was 1.6 years.

    Main Results:

    • External fixation resulted in persistent pubic diastasis (1.5-4 cm) in all cases, but it was asymptomatic.
    • Complications included implant failure (3 patients) and postoperative infection (2 patients).
    • Excellent/good clinical outcomes were achieved in most patients with type II (4/5) and type III (7/7) lesions.

    Conclusions:

    • External fixation is a suitable treatment option for patients with pelvic ring fractures who are poor surgical candidates.
    • Evidence does not conclusively favor single versus dual plating for pubic symphysis fixation.
    • Dual plating is recommended for osteoporotic patients with pubic symphysis instability.