Treatment of unstable pelvic fractures: use of a transiliac sacral rod for posterior lesions and an external fixator for anterior lesions.
BACKGROUND
This study sought to define the role of transiliac sacral rods used in combination with an external fixator for the management of unstable pelvic fractures.


METHODS
This retrospective study evaluated cases in which the surgical strategy was open reduction and internal fixation of posterior lesions with two transiliac sacral rods and closed reduction and external fixation of anterior lesions with an AO external fixator. The data for 65 cases were analyzed. Comprehensive Classification (AO) identified 42 C1 cases, 21 C2, cases and 2 C3 cases. Fractures with iliac bone involvement that impeded the application of an external fixator or transiliac sacral rods were excluded. The follow-up period was 85 months (range, 24-140 months).


RESULTS
All the fractures/dislocations healed well. The complications involved 17 cases (26.2%) of persistent posterior pain, 16 cases (24.6%) of irreversible neurologic deficit, 2 cases (3.1%) of posterior wound infection, 3 cases (4.6%) of pin tract infection, and 4 cases (6.2%) of irreversible urologic deficit. The functional results showed that the surgical results were satisfactory in 42 cases (64.6%) and unsatisfactory in 23 cases (35.4%).


CONCLUSIONS
For type C pelvic fractures without significant iliac bone involvement, surgical management with posterior transiliac fixation using sacral rods and anterior external fixation yields good radiologic results. The functional results correlated primarily with avoidance of complications and not necessarily with the radiologic results.
Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, and the National Yang-Ming University, Taiwan, Republic of China. fychiu@vghtpe.gov.tw
Fang-Yao
FY
Chiu
Tien-Yow
TY
Chuang
Wai-Hee
WH
Lo
D000293:Adolescent; D000328:Adult; D000368:Aged; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D012445:Sacrococcygeal Region; D016896:Treatment Outcome