Surgical treatment of the unstable type C pelvic injury

Abstract

Rotationally and vertically unstable injuries to the pelvic ring (Type C) require stabilisation of the anterior and posterior pelvic ring complex. Inadequate treatment of these injuries leads to chronic instability of the pelvic ring, which can finally cause permanent disability. Open reduction and stable internal fixation of the anterior and posterior complex of unstable pelvic ring injuries are standard procedures in the treatment of hemodynamically stable patients with (Type C) pelvic injuries. Our aim is to show that this type of treatment achieves excellent and good results. All patients were operated on using the method of open reduction and anterior plate fixation of sacroiliac complex as well as fixation of the pubic symphisis. We present a retrospective study of the results concerning the treatment of 19 patients with (Type C) unstable pelvic injuries. The average age of the patients was 43,21 years old. The final functional results, 2 years post-surgery according to the Majeed scoring system and the results were excellent in 11 (57.89%) and good in 8 (42.1%) patients. There were no bad results to report. Type C pelvic ring injuries are unstable and unless they are adequately treated, they can lead to permanent consequences. Surgical treatment that includes open reduction and stable internal fixation of the anterior and posterior pelvic ring complex leads to excellent and good results. The patients that were treated surgically by fixation of the anterior and posterior pelvic ring complex return to their everyday lives and work activities.

Biomechanical Comparison of Three Internal Fixation Techniques for Stabilizing Posterior Pelvic Ring Disruption: A 3D Finite Element Analysis

“…Posterior pelvic ring disruption remains a challenging problem for orthopaedic surgeons. The major surgical aim of posterior pelvic ring disruption is to promote the recovery of postoperative biomechanics of the posterior pelvic ring. Therefore, the more that postoperative pelvic stress can approximate its natural stress, the better the clinical efficiency that can be achieved by an internal fixation system.…”

Surgical treatment of unstable pelvic ring injuries

“…Kellam et al report that women usually complain of dyspareunia after lateral compression injuries [15]. Oliver et al found that 31% of female patients from their study sample had dyspareunia but this did not [17]. In our series of first 26 patients the average Majeed score was 72.1.…”

Pelvic ring injuries

“…Due to all these facts, it can be considered that these injuries need to be treated in highly specialized institutions using a multidisciplinary team approach. In hemodynam-ically stable patients, the method of choice is the definitive fixation of anterior or both anterior and posterior pelvic ring complex (type B and C injuries) (6,37). Definitive stabilization of the pelvic ring should be obtained as early as possible, preferably within the first seven days after the initial trauma (4).…”

“…Fixation of pelvic ring in emergencies is generally temporary and it is achieved with external fixation or by pelvic C clamps (4,5). After stabilization of the general health status, it is necessary to perform a stable pelvic ring fixation and restore the patient to prehospital activity (6).…”