Outcome of Open Reduction and Internal Fixation of Traumatic Unstable Pelvic Ring Fractures

Background: High energy trauma is responsible for pelvic fractures and multi-disciplinary approach is demanded for their management. The main objective of treatment should be the stability of haemodynamics. The stability of reconstructed pelvic ring should be the aim of any surgery that is carried out. Aim: To study physical function and X-rays result of unstable pelvic ring fractures that were surgically managed by open reduction and internal fixation. Methods: This retrospective study included a series of 30 patients who sustained unstable pelvic ring fractures as a result of road traffic accident during the period 1432-34 (2011-2013) and were managed surgically with open reduction and internal fixation at Prince Mutaib Bin Abdul Aziz Hospital Sakaka, Aljouf, Saudi Arabia. Patient's age was 18-55 years. All were males. We followed Tile's classification. Seventeen patients had type B and 13 patients had type C fractures. Modified Stoppa surgical approach was followed. Majeed score system was helpful for grading quality of reduction of pelvic ring fractures. Results: The mean age of patients was 38.70 years (range 18-55 years). Strictly adhering to Tile's classification, there were 17 type B and 13 type C pelvic fractures. Seven patients sustained additional injuries. The lower extremity fractures being the commonest additional injury. The mean follow-up was 21.93 months (range 10-18 months). Function was excellent in 70.5%, good in 17.6% and fair in 11.9% of total patients with type B pelvic ring fractures while it was excellent in 76.9%, good in 15.9% and fair in 7.7% of total patients with type C fractures. We noticed infection post-operatively in only one patient. There was no neurological deficit or any impairment in sexual function post-operatively. Conclusion: Rigid surgical stabilization emerged as the best management for unstable pelvic ring fractures in our study. It must be carried out as soon as the general condition of the patient permits and even upto two weeks post-injury.