Prof. Abd Elbary Hassan Abel Wahab Gouda :: Publications:

A¬BSTRACT: Background: Unstable pelvic ring disruptions are often associated with significant morbidity and mortality specially in patients with multiple injuries. Unstable pelvic fractures with marked displacement need reduction and fixation. Improved results of internal fixation over conservative (traction) treatment have been documented. The external fixation is a simple, safe and effective method for treatment of such injuries. Material and Methods: Over a period of 3 years, 22 patients with unstable pelvic ring disruptions (not including acetabular fractures) were treated by closed reduction and posterior fixation with 2 transiliac sacral rods and anterior external fixation (Hoffmann external fixator) using the percutaneous supra-acetabular route. According to Tile classification (1996), 15 cases (68.2%) were grouped as type C1, 5 cases (22.8%) as C2 and 2 cases (9%) as C3. The pelvic scale described by Pohlemann et al., (1996) was used for both clinical and radiological assessment. The follow up period ranged from 8 – 20 months (mean 12 months). Results: All the fractures and dislocations healed well. According to the pelvic outcome score, the final results were excellent in 3 cases (13.6%), good in 9 cases (41%), fair in 8 cases (36.4%) and poor in 2 cases (9%). The complications involved 3 cases (13.6%) of posterior wound infection, 5 cases (22.8%) with superficial pin-tract infection and 2 cases (9%) with irreversible neurologic deficit. Conclusion: Reconstruction of type C unstable pelvic fractures using posterior transiliac sacral rods and anterior external fixation yields good results. The functional results correlated primarily with avoidance of complications and not necessarily with the radiological results.