Surgical Treatment of Pelvic Ring Injuries

Abstract

The treatment of unstable pelvic ring fractures is a major challenge even without vascular compromise, as these fractures are rare injuries and the caseload is small at smaller hospitals. Therefore the definitive treatment of unstable pelvic ring and acetabular fractures should be centralized at the biggest trauma hospitals. Good reduction together with proper stabilization allows early mobilization, prevents complications, and, thereby, leads to a short hospital stay and an early start of rehabilitation. In type C pelvic ring injuries internal fixation of displaced and unstable rami fractures and symphyseal disruptions in conjunction with posterior fixation seems to yield better stability for the whole pelvic ring. Several authors have associated good reduction result with favourable long-term results. It is also documented that the permanent lumbosacral plexus injury is a strong prognostic factor. The clinical results suggest that special attention should be paid on pre-operative planning, reduction of the fracture, decompression of the nerve roots, and stable internal fixation of all main fracture components.