Acute Definitive Internal Fixation of Pelvic Ring Fractures in Polytrauma Patients: A Feasible Option

Abstract

Acute ORIF of unstable pelvic ring fractures within 6 hours could be safely performed even in severely shocked patients with multiple injuries. The procedure did not lead to increased rates of transfusion, mortality, intensive care unit LOS, or overall LOS. Furthermore, all these parameters showed a trend toward benefit compared with a staged approach.

Management of pelvic fractures

“…Acute ORIF of unstable pelvic ring fractures was shown to be well tolerated in hemodynamically unstable patients with multiple injuries. This procedure did not lead to increased rates of transfusion, mortality, ICU length of stay, or overall hospital length of stay [37 ].…”

Anatomic Determinants of Sacral Dysmorphism and Implications for Safe Iliosacral Screw Placement

“…The sacral dysmorphism score quantifies dysmorphism and can be used in preoperative planning of iliosacral screw placement. P ercutaneous iliosacral screw fixation has been widely adopted as a safe method for treatment of unstable pelvic ring injuries [1][2][3][4][5][6][7] . The use of iliosacral screws is increasing, probably as a result of increased training in the technique, an increase in the incidence of pelvic ring injuries, and increased survival of patients with unstable pelvic ring injuries 8,9 .…”

Internal versus external fixation of the anterior component in unstable fractures of the pelvic ring: pooled results from a systematic review

“…With either of these complications the patient is at increased risk for poor long-term outcomes and this represents a significant weakness of external fixation as a treatment option. In cases where external fixation is necessary it makes sense to manage patients initially with external fixation and subsequently switch to internal fixation as in the study by Enninghorst et al [18].…”