PRIMARY EXTERNAL FIXATION OF ROTATIONALLY UNSTABLE PELVIC FRACTURES IN OBESE PATIENTS

Background: Patients with obesity who undergo surgery have an increase d risk for perioperative complications. The purpose of this study was to determine the perioperative outcome of rotationally unstable pelvic fractures treated with initial external fixation in obese patients. M ethods: Review of clinical data and radiographs of 42 patients identif ied from a prospectively entered trauma database who had rotationally unstable fractures of the pelvis treated with initial pelvic external fixation. Results: Inability of an anterior uniplanar external fixator to maintain adequate reduction of the pelvic ring disruption occurred with a greater frequency in obese patients compared with nonobese pat ients (p < 0.005). The anterior frame was unable to provide sufficient stabilization of the pelvic ring disruption in all obese patients wit h pure open-book-type fractures. For these patients, stabilization of the pelvic ring was achieved with early symphyseal plating. Conclusion : We report a significantly higher incidence of inability to obtain or maintain reduction of open-book pelvic fractures in obese patients us ing primary anterior uniplanar external fixation, Early symphyseal pla ting allowed early patient mobilization and maintained acceptable redu ction throughout the follow-up period.