A study on functional outcome of surgical management in unstable pelvic fractures: A prospective study

Author(s): Dr. Nadar Raja Chidambaram and Dr. Venkatachalam K

Abstract: The initial management of life-threatening haemorrhage associated with unstable pelvic fractures has long been a source of debate. A review of the literature reveals that many advocate emergent orthopaedic external fixation (EX-FIX) for severe pelvic fractures, whereas others claim greater success with angiographic embolization (ANGIO- EMBOLIZATION) as the first line of treatment. Subsequent management either to retain the External-fixator or to proceed with ORIF after the patient’s clinical condition stabilizes is a matter of debate. Although many have attempted to outline management options by the nature of fracture pattern, to date there has been no prospective trial comparing outcomes for each method of treatment. We offer a prospective study of unstable [Tile type B and C] pelvic fractures in patients admitted to our Trauma Centre between March 2017 to Feb 2018. Patients were classified according to the fracture pattern and the degree of haemo-dynamic instability. Those patients who presented in a haemo-dynamically unstable condition, had their clinical condition stabilized. Certain of these cases had preliminary External- Fixators applied for their pelvic fractures. All cases, subsequently were definitively treated with Open Reduction and Internal Fixation. In our series of 20 patients whose functional outcomes were evaluated at the end of 8 months post -operatively, 20% (n =4) had Excellent, 60% (n = 12) had Good, 10% (n = 2) had Fair and 10% (n = 2) had Poor outcome, as evaluated by the Cole et al; Scoring System. Our study concluded that in unstable pelvic fractures Open Reduction and Internal Fixation after haemo-dynamically stabilizing the patient, gives good clinical, radiological and functional outcomes.

DOI: https://doi.org/10.22271/ortho.2019.v5.i1c.26