title: Diagnosis and treatment of unstable fractures of the pelvic ring.
abstract: The operative treatment of unstable fractures of the pelvic ring has gained upon the conservative treatment during the last years. The anatomical reconstruction and the stability of the bony structures allow a rapid postoperative mobilization and avoid the complications due to a difficult nursing and a long-time bedrest. The operative management could significantly diminish the mortality and morbidity in multitraumatized patients. The most recent classification of fractures of the pelvic ring pays great attention to the trauma mechanism and the degree of instability. Also in diagnostic procedures the surgeon pays attention to the stability of the dorsal pelvic ring. The value of CT-images is greater than the conventional roentgenograms in evaluating fracture form, dislocation and instability. A primary operative treatment is only necessary in certain emergency situations. All other operations can be carried out secondarily on the stable and well prepared patient. The external fixation is a simple procedure in emergency situations. In secondary operations we have the choice between the plate osteosynthesis on the ventral pelvic ring and a plate osteosynthesis or a transarticular arthrodesis on the dorsal pelvic ring. 53 of 62 patients with unstable fractures of the pelvic ring were operated upon in the Department of Traumatology of the University Clinic of Essen. The postoperative complications are reviewed and discussed. The invalidity in patients with fractures of the pelvic ring is more dependent on the lesions of the intra- or extrapelvic structures accompanying the fractures, than on the fractures themselves.
mesh_terms: D000328:Adult; D001174:Arthrodesis / Q000379:methods; D001860:Bone Plates; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed