Treatment of open pelvic fractures with external fixation and vacuum sealing drainage

Abstract

ObjectiveTo report outcomes of treating open pelvic fractures with external fixation and vacuum sealing drainage.MethodsSeven open pelvic fractures patients were treated at our hospital from November 2004 to April 2010. They were 3 males and 4 females, aged from 2 to 43 years (mean, 29. 3years). The fractures were caused by traffic accidents (4 cases), falling (one case), smashing (one case) and crushing (one case). According to the Tile classification, 5 were type B1, one was type B2 and one type C1.All were complicated with injuries to soft tissue and organs. By the Gustilo-Anderson classification, open injury was all type Ⅲ, involving soft tissues around the ilium, hip, perineum and inguina. The injury severity score (ISS) ranged from 29 to 57(average, 40.4) . The fractures were treated with external fixation and the wounds with vacuum sealing drainage.ResultsOne patient died during early treatment and 3 had to sustain amputation of the acetabulum. Six patients were followed up for 1.5 to 67 months (mean, 27.6 months). Five patients reported good functional response in fracture healing and fine wound repairing outcome.One case reported good tissue generation after wound skin grafting and fundamental fracture healing. Two cases respectively reported erectile dysfunction of penis and functional disorder of defecation.ConclusionIn treatment of open pelvic fractures, external fixation and vacuum sealing drainage can effectively stabilize the pelvic ring and reduce bleeding and complications as well. Key words: Pelvis; Fractures, open; External fixator; Drainage