B Hari Krishnan1, Yogesh Sharma2, Girish Magdum3. 1. Associate Professor, Dept of Orthopaedics, Armed Forces Medical College, Pune 411040, India. 2. Professor and Head, Dept of Orthopaedics, Armed Forces Medical College, Pune 411040, India. 3. Resident, Dept of Orthopaedics, Armed Forces Medical College, Pune 411040, India.
Abstract
BACKGROUND: Unstable posterior pelvic and sacroiliac joint injuries are challenging fractures mostly managed conservatively in our military hospitals till date. We carried out a retrospective analysis of early fixation of these fractures at our hospital and compared it with the existing literature as regards its safety and efficacy. METHODS: A retrospective analysis of all patients admitted and managed by internal fixation for unstable posterior pelvic fractures was carried out for evaluation of its efficacy and safety. All patients with unstable posterior pelvic fractures were managed by early closed reduction percutaneous sacroiliac fixation using a radiolucent fracture table and image intensifier after a CT evaluation. RESULTS: A total of 24 patients were admitted with pelvic fractures, out of which 18 who had posterior pelvic ring injuries requiring fixation were included in the study. 21 percutaneous SI screws were inserted in 17 patients. All patients had satisfactory initial reduction as per Starr's criteria and recovered to their full - pre-injury functional status without any major intra-/postoperative complications, at a minimum of 12 months of follow-up. CONCLUSION: Unstable pelvic fractures must be managed by early reduction internal fixation to reduce morbidity and mortality arising out of such injuries. Closed reduction percutaneous fixation of these injuries is a safe procedure to be carried out in our set-up equipped with radiolucent fracture table and image intensifier by trained surgeons. The management of these injuries is likely to become easier in future with the advent of navigational aids in management of complex pelvic and acetabular fractures.
BACKGROUND: Unstable posterior pelvic and sacroiliac joint injuries are challenging fractures mostly managed conservatively in our military hospitals till date. We carried out a retrospective analysis of early fixation of these fractures at our hospital and compared it with the existing literature as regards its safety and efficacy. METHODS: A retrospective analysis of all patients admitted and managed by internal fixation for unstable posterior pelvic fractures was carried out for evaluation of its efficacy and safety. All patients with unstable posterior pelvic fractures were managed by early closed reduction percutaneous sacroiliac fixation using a radiolucent fracture table and image intensifier after a CT evaluation. RESULTS: A total of 24 patients were admitted with pelvic fractures, out of which 18 who had posterior pelvic ring injuries requiring fixation were included in the study. 21 percutaneous SI screws were inserted in 17 patients. All patients had satisfactory initial reduction as per Starr's criteria and recovered to their full - pre-injury functional status without any major intra-/postoperative complications, at a minimum of 12 months of follow-up. CONCLUSION: Unstable pelvic fractures must be managed by early reduction internal fixation to reduce morbidity and mortality arising out of such injuries. Closed reduction percutaneous fixation of these injuries is a safe procedure to be carried out in our set-up equipped with radiolucent fracture table and image intensifier by trained surgeons. The management of these injuries is likely to become easier in future with the advent of navigational aids in management of complex pelvic and acetabular fractures.
Authors: Robert L Sciulli; Richard H Daffner; Daniel T Altman; Gregory T Altman; Jeffrey J Sewecke Journal: AJR Am J Roentgenol Date: 2007-02 Impact factor: 3.959