Faculty Collaboration Database

13-Year experience in external fixation of the pelvis: complications, reduction and removal. Eur J Trauma Emerg Surg 2016 Feb;42(1):91-6

Date

06/04/2015

Pubmed ID

26038020

DOI

10.1007/s00068-015-0499-7

Scopus ID

2-s2.0-84958040145 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

PURPOSE: To evaluate the complications associated with anterior pelvic external fixation and the success of this device in maintaining reduction when used in conjunction with sacroiliac screws.

METHODS: Through a retrospective clinical study at an academic Level I Trauma Center, 129 patients fit the criteria for inclusion with a mean duration of anterior pelvic external fixation of 62 days and mean follow-up of 360 days. Charts were reviewed for complications postoperatively. The symphysis diastasis, vertical displacement and posterior displacement of each hemipelvis were quantified from pelvic radiographs.

RESULTS: Of the 129 patients receiving anterior pelvic external fixation, 14 (10.9 %) presented to an emergency department for problems with their anterior pelvic external fixation. Of these 14 patients, 7 (5.4 %) required readmission, all for infectious concerns necessitating IV antibiotics. 6 (4.7 %) required formal operative debridement and device removal. 13 patients (10.1 %) had superficial pin site infections successfully treated with oral antibiotics. Reduction was maintained (rated as fair, good or excellent) in all patients with radiographic follow-up (n = 74, average radiographic follow-up of 216 days) following removal of their anterior pelvic external fixation. 38 patients (30.4 %) had their anterior pelvic external fixation removed in clinic, while 87 (69.6 %) had formal removal in the operating room.

CONCLUSION: While previous data suggest high complication rates in definitive anterior pelvic external fixation, we present the largest cohort of patients receiving anterior pelvic external fixation and sacroiliac screws, demonstrating a low complication rate while maintaining reduction of the pelvic ring. In addition, we found that these devices could be reliably removed in a clinic setting.

Author List

Mitchell PM, Corrigan CM, Patel NA, Silverberg AJ, Greenberg SE, Thakore RV, Obremskey WT, Ehrenfeld JM, Evans JM, Sethi MK

Author

Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Bone Screws
External Fixators
Female
Fracture Fixation
Fractures, Bone
Humans
Ilium
Male
Middle Aged
Pelvic Bones
Retrospective Studies
Sacrum
Treatment Outcome
Young Adult