Operative treatment of crescent fracture of the pelvis by posterior approach

Abstract

Objective To explore the efficacy of posterior approach in treatment of crescent pelvicfracture. Methods Between April 2007 and January 2010, 12 patients with crescent pelvic fracture were treated via posterior approach at our department. They were 8 men and 4 women, aged from 21 to 55 years （average, 31.3 years）. Six left and 6 right sides were affected. The fractures were caused by a traffic accident in 8 cases, high falling in 3 cases and heavy weight crushing in one. By Tile classification, there were 8 cases of type B2. 1 and 4 cases of B2.2. The time from injury to operation was 3 to 9 days, with an average of 6.2 days. They were treated with open reduction and internal fixation via the posterior approach. Operation time, intraoperative blood loss, postoperative loss of pelvic ring reduction, fracture healing time and Hannover pelvic outcome scoring were documented. Results The average operation time was 172.5 ±34. 1 minutes（from 120 to 240 minutes） . The average blood loss was 412.5±128. 1 mL（from 250 to 700 mE） . The average reduction gained was 11.7±4.6 mm（from 6 to 21 mm）, Ten patients obtained an average follow-up of 16.3 months （from 12 to 20 munths）. The X-ray films showed bony healing in all patients after an average of 3. 1 ±0.3 months（from 3 to 4 months）. There was no postoperative loss of pelvic, ring reduction or implant failure. By the Hannover scoring system, 7 patients were rated as excellent and 3 as good in clinic symptoms, and complete social reintegration was obtained in 8 cases and incomplete one in 2 cases. Conclusion Operation via posterior approach is a good choice for treatment of crescent pelvic fracture. Key words: Pelvis; Fractures; Sacroiliac joint; Fracture fixation, internal