Citation

Tosounidis TH, Sheikh HQ, Kanakaris NK, Giannoudis PV. Injury 2017; 48(6): 1139-1146.

Affiliation

Academic Department of Trauma & Orthopaedic Surgery, Clarendon Wing, Floor D, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA West Yorkshire, Leeds, UK. Electronic address: pgiannoudi@aol.com.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.injury.2017.03.033

PMID

28363753

Abstract

OBJECTIVES: To analyse the complications and outcomes (functional/radiographic) of Pelvic External Fixators applied as part of the definitive fixation in polytrauma patients.

DESIGN: A single center retrospective chart review. SETTING: A level-1 trauma center.

PATIENTS AND METHODS: We reviewed all the polytrauma patients (ISS>16) between 2007 and 2012 that had a PEF applied more than 30days. Complications including infection, aseptic loosening, neurological injury, loss of reduction, non-union and mal-union were recorded. Pelvic asymmetry and Deformity Index (DI) were measured at the immediate postoperative radiographs and final follow-up. The functional outcome at final follow up was estimated using a scale previously reported by Chiou et al.

RESULTS: 59 patients with mean age of 38.4 (16 - 81) years and mean ISS score 28 (16- 66) were included. The PEFs were applied for mean duration of 56 (30-104) days. The average follow-up was 403days. 22 injuries were type B and 37 type C (AO/OTA). The most common symptomatic complications were pin site infection in 11 (18.6%) and loosening in 5 (8.5%) cases. 44 (74.5%) patients had satisfactory functional outcome. The immediate post-operative and final asymmetry and DI were compared between the two pelvic injury groups (type B and C fractures). The difference in displacement progression was more for type C injuries (p=0.034) but no correlation to the functional outcome was evident.

CONCLUSION: PEF can be used as definitive alternative stabilization method in specific situations at polytrauma setting. Radiological displacement occurred in both type B and C injuries but the clinical outcome was not correlated to this displacement. Complications related to PEF do not affect the final clinical outcome. LEVEL OF EVIDENCE: Therapeutic Level III.

Copyright © 2017 Elsevier Ltd. All rights reserved.

Language: en

Keywords

Pelvic external fixator; Pelvic ring injuries; Polytrauma