DISRUPTION OF THE POSTERIOR PELVIC RING - RESULTS OF OPERATIVE STABILIZATION

Complete disruptions of the posterior pelvic ring are rotationally and vertically unstable [type C according to the Tile/AO(ASIF) classifica tion (1991)]. Usually operative treatment is required. The data on 24 patients over a 5-year period were analyzed. Thirteen patients were fe male (54.2%) and 11 male (45.8%); the average age was 32.8 years. Mult iple trauma was present in 20 patients (83.3%). In most cases operativ e stabilization of the posterior pelvic ring was performed by lag scre ws from the ilium into the body of the sacrum. The mortality in this s eries was 16.7% (4 patients). One patient had a thrombosis of the femo ral and pelvic veins. In 2 patients we had to perform a second operati ve procedure because of lag screws that had not been precisely placed or had dislocated. Two incisions healed secondarily. On the postoperat ive radiographs in 3 patients a slight deformity of the pelvic ring wa s visible; in another patient the reduction of the injured hemipelvis was not sufficient. The 20 survivors had a clinical and radiological e xamination on average 27.5 months after their injury. Eleven patients were without pain, while 9 complained of low back pain. Gait disturban ces were found in 8 patients; in 2 of them this was due to associated injuries. Five patients were unable to work. Eight patients had neurol ogical deficits, some of them minor. Additional complications were imp otence (3 patients), urinary (2 patients) or fecal incontinence (1 pat ient), and dystocia requiring a cesarian section (1 woman) [multiple e ntries]. Radiological findings (deformity of the pelvic ring, heteroto pic ossifications, arthrosis of the sacroiliac joint, SI joint fusion) did not necessarily correlate with the patients' complaints. Our resu lts correspond with the findings of other authors. Even adequate opera tive treatment cannot restore complete function in all patients, who s urvive disruption of the posterior pelvic ring.