[Results of follow-up of conservatively and surgically treated injuries of the pelvic ring within the scope of a prospective study].
Follow-up was possible after an average of 23.4 months in 26 cases of pelvic ring injury. These were made up of 7 type A, 8 type B, and 11 type C injuries. Every type A lesion was treated conservatively. External fixation and conservative management were used with type B injuries. Besides conservative treatment both internal and external surgical procedures were applied for correction of type C fractures. While patients treated for type A injuries reported hardly any pain at follow-up, those with types B and C reported dorsal pelvic ring pain of comparable intensity regardless of the treatment given. All patients with a poor outcome following unstable pelvic ring injuries reported dorsal pelvic pain as a principal symptom. Radiological evaluation revealed that the greater the dorsal displacement the more acute the dorsal pain must be expected. An anatomical reduction does not guarantee freedom from pain, however. Besides pain we also rated hip joint flexibility and ability to walk according to the Merle D'Aubigné score. Trauma-related damage and postoperative injuries were distinguished in the neurological evaluation showing a high incidence of lesions of the lateral cutaneous nerve of the thigh following external pelvic fixation. Because of their pelvic injuries 6 patients (23%) were completely or partly disabled and thus unfit for work. The follow-up examinations showed good results in 20 (76%) of the cases. While type B pelvic ring injuries can heal completely when treated by means of a supra-acetabular pelvic fixator, reliable retention cannot be achieved in the case of type C lesions.
Draijer
F
F
Klinik für Unfallchirurgie, Christian-Albrechts-Universität Kiel.
Egbers
H J
HJ
Havemann
D
D
Zimmermann
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000145:classification / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000145:classification / Q000601:surgery*; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D016896:Treatment Outcome
Nachuntersuchungsergebnisse konservativ und operativ behandelter Beckenringverletzungen im Rahmen einer prospektiven Studie.