The pelvic ring is considered stable under type A fractures, and it doesn’t need any fixation. However, according to our observations, the ischiopubic component is mobile thereby depriving of the patients’ mobility and contributing to the development of hypostatic complications.

Кустуров В.И., Горня Ф.И., Кустурова А.В., Гагауз И.М.

Abstract


Purpose. To increase the efficiency of treating fractures of the bones forming the anterior pelvic ring in the injured persons with polytrauma.
Materials and Methods. Clinical-and-radiological analysis of treatment results made in 154 injured persons with polytrauma, type A fractures of pelvic bones. Conservative treatment performed in the first group (n=28), and surgical treatment using the developed little-invasive devices and pelvis osteosynthesis techniques performed in the second group (n=126). Multiple injuries of the anterior pelvic ring (of Type А2.3) prevailed in patients of this group – 101 (65.58%) cases.
Results. 12 patients of the first group completed their treatment with good consolidation of fragments in proper position, callus transformation with gross deformity in the sites of fragmental union observed in 16 patients after vertical weight-bearing started. Open reposition and internal fixation using Matta Pelvic System instruments performed in four (4) cases, and delayed closed reposition with an external fixator – in 12 cases. Patients of the second group underwent early stabilization of the pelvic ring thereby providing safe examination and care of patients while combining the time-period of treating the injuries of internal organs and pelvis. Fixation of pelvic ring fractures with an external fixator was possible at all the stages of traumatic disease, and it provided positive results in all the cases. The time-periods of pelvic ring fixation with an external fixator were 58.83±1.31 days (p less 0.05). The results of treatment evaluated by S.A. Majeed score system. Good results obtained in 67.53% of cases and satisfactory ones – in 29.87% ofcases.
Conclusion. Early osteosynthesis of type A pelvic fractures with an external fixator in case of polytrauma is animportant antishock measure creating optimal conditions to recover the pelvic ring integrity and contributing to treatment result improvement.

Keywords


pelvis, anterior pelvic ring fractures, treatment, an external fixator

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