The role of external osteosynthesis in treatment of unstable pelvic osseous injuries

N L Аnkin,T M Petryk,V А Ladyka,L N Аnkin

doi:10.26779/2522-1396.2019.05.48

Abstract

Objective. To specify the role and indications for application of аpparatus of external fixation (АEF) in treatment of unstable pelvic osseous injuries (UPOI); to study up the advantages and faults of the external fixation method; to share the experience of treatment, using this procedure. Маterials and methods. There were 229 patients, suffering pelvic injuries, examined on the base of orthopedic-traumatological centre of Kyiv’s Regional Clinical Hospital in 2005 - 2017 yrs and distributed into three Groups. In Group I 143 (62.4%) injured persons were included, in whom external osteosynthesis played the function of temporary measures of fixation, in Group II - 27 (11.8%) patients, in whom while hospitalization a fracture was fixed, using AEF, аnd after stabilization of the state the posterior pelvis osteosynthesis and reposition was conducted, in Group III - 59 (25.8%) patients, who, using several indications, were definitely treated, applying the external fixation method only. Results. Excellent effect of treatment in Group I was registered in 23 (19.0%), a good one - in 58 (47.9%), satisfactory - in 32 (26.4%), poor - in 8 (6.6%) of 121 patients; in Group II - accordingly, - in 5 (20.8%), 11 (45.8%), 7 (29.2%) and 1 (4.2%) of 24 patients; in Group III - accordingly, in 4 (8.3%), 12 (25%), 23 (47.9%) and 9 (18.6%) of 48 patients. Conclusion. Best results of treatment of patients with unstable pelvic osseous injuries were obtained while applying the tactics of change from external fixation into internal one. On the first stage the pelvic ring fixation, using AEF, was performed, аnd after stabilization of a patient general status - internal osteosynthesis. Application of the internal osteosynthesis method permits to control and stabilize the reposition achieved, to conduct the sacro-ileal joint revision.

Highlights

In Group I 143 (62.4%) injured persons were included, in whom external osteosynthesis played the function of temporary measures of fixation, in Group II – 27 (11.8%) patients, in whom while hospitalization a fracture was fixed, using AEF, аnd after stabilization of the state the posterior pelvis osteosynthesis and reposition was conducted, in Group III – 59 (25.8%) patients, who, using several indications, were definitely treated, applying the external fixation method only
Excellent effect of treatment in Group I was registered in 23 (19.0%), a good one – in 58 (47.9%), satisfactory – in 32 (26.4%), poor – in 8 (6.6%) of 121 patients; in Group II – – in 5 (20.8%), 11 (45.8%), 7 (29.2%) and 1 (4.2%) of 24 patients; in Group III – in 4 (8.3%), 12 (25%), 23 (47.9%) and 9 (18.6%) of 48 patients
Best results of treatment of patients with unstable pelvic osseous injuries were obtained while applying the tactics of change from external fixation into internal one

Summary

Роль внешнего остеосинтеза в лечении нестабильных повреждений костей таза

The role of external osteosynthesis in treatment of unstable pelvic osseous injuries. Уточнить роль и показания к применению аппарата внешней фиксации (АВФ) при лечении нестабильных повреждений костей таза; изучить преимущества и недостатки метода внешней фиксации; поделиться опытом лечения с использованием данной методики. Были обследованы 229 пациентов с повреждениями таза, которых мы разделили на три группы. В 1 –ю группу вошли 143 (62,4%) пострадавших, у которых внешний остеосинтез выполнял функцию временного средства фиксации, во 2 –ю группу – 27 (11,8%) пациентов, которым при госпитализации перелом фиксировали АВФ, а после стабилизации состояния выполняли репозицию и остеосинтез заднего отдела таза, в 3 –ю группу – 59 (25,8%) пациентов, которым по разным причинам окончательное лечение проводили исключительно методом внешней фиксации. Лучшие результаты лечения пациентов с нестабильными повреждениями костей таза получены при применении тактики замены внешней фиксации внутренней. Ключевые слова: нестабильные повреждения костей таза; замена метода; аппарат внешней фиксации; металлоостеосинтез.

Objective

Findings

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