Abstract: Background: Pelvic ring injuries are commonly encountered in high energy trauma, representing one of the most challenging clinical problems in which an urgent multidisciplinary the approach is required. Pelvic fractures are the third most common cause of death in road traffic accidents, following central nervous system and chest injuries. Pelvic injuries are a source of significant morbidity and mortality with rates ranging from 5 to 20%.
Aim: To study the functional outcome of percutaneous fixation of unstable pelvic ring disruptions.
Materials and Methods: 20 patients admitted in government thoothukudi medical college hospital thoothukudi with pelvic injuries with unstable type B and type C were included in this prospective study. All the patients were treated based on our inclusion and exclusion criteria. Only Tiles B and C fractures were included in this study.
Results: 20 patients with pelvic fractures admitted at Government Thoothukudi medical college hospital, Thoothukudi were included in the study. The mean age was 37.5 yrs. The age group between 31 to 50 dominates the series accounting for 64% of cases.
Pelvic fractures caused by road traffic accidents include 17 fractures (85%) and accidental fall 3 fractures (15%).
The average time from injury to surgery was 14 days (range 4 to 28 days), our mean operative time was 45 minutes. All the patients were treated with percutaneous fixation with cannulated cancellous screws.
All patients were regularly followed up once a month for three months, then at three months interval there after. Standard antero posterior xray, lateral, and axial CT views were taken at discharge, 3months, at the end of one year and at latest review.
5 out of 20 patients had complications associated with surgery. One patient had wound infection and had to undergo implant exit. Two patients had fracture mal reduction in the postop radiograph showing persistent displacement of fracture fragments. However, this did not alter the functional outcome significantly.
Two patients had screw malposition on postoperative CT scan with violation of neural foramen. However this did not result in neurological deficits.
Functional evaluation was done using Majeed pelvic injury functional outcome score. All operated cases were followed up for maximum period of two years and minimum of one year.
The Majeed pelvic injury functional outcome score at the end of one year is excellent in 12 cases (60%),good in 5 cases (25%),fair in 3 cases(15%) and poor in no cases. The average score was 80% among all patients at the latest follow up.
Conclusion: Percutaneous screw fixation for pelvic fractures is in our opinion, a reliable and reproducible technique. Functional outcome in our study was good to excellent in 85% of cases as per the majeed pelvic scoring system. The score is found to be significantly higher in those cases without associated lower limb or spine fractures showing the impact on delayed weight bearing in associated fractures.
