Modern concepts of external skeletal fixation of the pelvis

The treatment of unstable pelvic ring fractures, markedly comminuted and displaced acetabular fractures and combinations of these insults to the pelvis is an unsolved problem. Of all the previously described methods, external fixation has appeared to hold the most promise for certain pelvic bone injuries of major proportions which are accompanied by instability of the pelvic ring. Many of the external fixation devices of the past have not provided adequate stability. A modification of the Hoffmann external frame provides a simple method of treatment for unstable pelvic ring fractures that immediately permits the patient to move from bed to chair. Complex pelvic and central acetabular fractures also are responsive to treatment by extensive external frames. While this external skeletal fixation is superior to previously available devices, internal fixation is under consideration for stabilization of the posterior portion of the pelvic ring. A combination of internal and external fixation may also be advantageous for severely disrupted pelvic bones.