Unstable pelvic ring injuries. Outcome and timing of surgical treatment by internal fixation

OBJECTIVE: To evaluate the radiological and functional results of surgical treatment of unstable pelvic injuries and to study the factors affecting the final outcome.

METHODS: Thirty-eight patients with unstable type C pelvic injuries from King Khalid University Hospital, Riyadh and North West Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia during the period January 1996 through to January 2001 were reviewed. There were 31 males and 7 females. The mean age was 37-years. Thirty-two patients had 76 associated skeletal fractures. A percutaneous iliosacral screw was carried out for all patients in the study. Anterior stabilization was needed for 23 patients.

RESULTS: There were 2 complications of fixation, an iatrogenic S1 root injury and dismantled symphyseal plate. The average hospital stay was 29 days and the average time to start mobilization was 15 days. The radiological result was satisfactory in 32 patients (84%) while functional result was satisfactory in 27 patients (71%).

CONCLUSION: Unstable pelvic ring injuries should be managed surgically and must be carried out as soon as the general condition of the patient allows, even up to 4-weeks.