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LONG TERM RESULTS OF NONOPERATIVE TREATMENT OF PELVIC RING INJURIES – AN ORTHOPAEDIC PERSPECTIVE

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Aims: Evaluation of: 1/ type and incidence of pelvic ring injuries, 2/ type and incidence of associated injuries, 3/ type of pelvic ring injuries pathomechanism, 4/ influence of pelvic ring injuries on trauma severity score, 5/ analysis of clinical long term results.

Material and methods: Retrospective evaluation of 257 patients with pelvic ring injuries treated between 1989–2003 had been made. Mean patients age was: 65 y.o. (Range: 32–61 y.o.). Mean follow-up time: 57,5 months (range: 18–192 m.). All patients were treated no operatively: bed-rest, hamaque suspension, and skeletal traction. Analysis of pelvic injuries was made by Tiles classification. Evaluation of pelvic injuries pathomechanism was made by Young-Burgess classification. Clinical end results were evaluated by Iowa Pelvic Score. In polytraumatized patients trauma severity was evaluated by AIS and ISS.

Results: Incidence of pelvic injury in hospitalized patients was 1,3%. In study group there were following pelvic injury types: type A – 14 %, type B – 77 % and type C – 9%. Pathomechanisms of pelvic injuries in study group were following: type LC – 61%, type APC – 30%, type VS – 2%, type CMI – 7%. Long term clinical results in Iowa pelvic Score were for pelvic ring injuries: type A – 92 p., type B – 86 p., type C – 67 p. Mean value of ISS index in patients with pelvic ring injuries was 23p, mean value of ISS index in patients without pelvic ring injuries was 19p.

Conclusions: 1/ pelvic ring injuries in standard orthopedic and traumatic department are rare, 2/ pelvic ring injuries are frequent in polytraumatized patients, 3/ type C according to Tile’s classification is the most frequent type of pelvic ring injury, 4/ type LC according to Young-Burgess classification is the most frequent type of pelvic ring injury pathomechanism, 5/ incidence of pelvic ring injury in polytraumatized patient increases ISS index, 6/ long term clinical results suggested that most pelvic ring injuries can be successfully treated nonoperatively.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.