Nonunion and delayed union of fractures of the pelvis

A review of 42 patients with delayed union and nonunion of fractures of the pelvis demonstrates that this rarely reported entity does exist. Nonunion occurred primarily in young patients (average age 35 years) and caused severe disabling symptoms. Bone graft surgery combined with external skeletal fixation of the pelvis produced union in 15 patients, each of whom was able to return to the work force. In the nonoperative group, only ten of 24 achieved bony union while 14 of those had only fibrous union. Pain in association with a limp were the predominant symptoms. Tangential radiographs of the pelvis, stress X-rays and tomograms proved the diagnosis. The average time to diagnosis in this series was 38 weeks. Earlier diagnosis and treatment are possible and would greatly reduce the morbidity of patients with extensively injured pelves.