Pelvic ring injuries: a challenge for the trauma surgeon.

A consecutive series of 105 patients with type B or type C pelvic ring lesions, which were treated operatively between 1987 and 1991, was reviewed retrospectively. 76 patients were also reviewed clinically and radiologically after a mean time of 20,7 months. The average ISS of all patients was 32,8, the peri-operative mortality was 12,4%. Eight deaths (7,6%) were pelvic trauma related deaths. 9,3% of patients with B-type lesions had associated neurological injuries and 24,2% of patients with C-type lesions. A second operative procedure was performed in 13,9% of B-type lesions and in 42,4% of C-type lesions. 79,1% of the patients with B-type fractures had excellent or good functional results and 57,6% of the patients with C-type fractures. The actual guidelines for primary and secondary operative management of patients with unstable pelvic ring injuries are exposed. An overview of possible concomitant intrapelvic lesions with their primary treatment is also presented.