(STUDY FOR FIXATION OF ROTATIONALLY AND VERTICALLY UNSTABLE PELVIS (EXPERIMENTAL AND OPERATIVE

Abstract

During the period between February 2000 and March 2002 our study was conducted to 1sscss functional outcome after internal fixation of vertically and rotationally unstable "ractures of the pelvic ring. Thirty patients with a mean age of31 years underwent open •eduction and internal fixation for pelvic ring injuries, which were vertically and 'ationally unstable either unilaterally or bilaterally. Fractures were classified according oth Young and Tile classification systems (Tile, 1996; Young et at., 1986). All ,auent., ere evaluated preoperatively using the standard radiographs: AP, inlet, and lUtlct views, and CT scan. Postoperatively, patients were followed-up for a mean of 12 nonths (range 6-24 months) and were evaluated using the Majeed score. The study was :ondueted with the aim of finding the best methods for fixing the different types of Jnstable pelvic ring injuries, assessing the functional outcome after the various -techniques and types of implants used and the union rate of pelvic fractures. The :>pcrative treatment consisted of a combination of anterior and posterior fixation in 20 cases, posterior internal fixation alone was used in 5 cases and anterior extemal fixation was added to posterior fixation in 5 cases. An experimental study was designed and conducted to test the strength of a newly designed plate for the purpose of dgid anterior segment internal fixation of the pelvic ring, and that can be used in rotationally unstable -fractures singly or combined with posterior internal fixation in vertically unstable fractures. The questions posed in our study are: 1) How docs the designed plate compare with a single 4.5mm reconstruction plate for anterior symphyseal fixation. 2) How does the anterior, posterior columns of the acetabulum, and the inferior pubic ramus behave in each situation of pelvic compression (APC,, LC), and shear. The data were analyzed by recording the strain measured from strain gages against time, and stati:-;tical analysis was done using the SPSS program. Our results revealed radiologically: none had poor radiological result, 17 patients were excellent, 11 were good, and 2 had fair reductions. The Majeed score (ly!ajeed, 1989) was used to evaluate the functional outcome. The mean score was 82 (range! 66•95) among the 29 Jiving patients, 21 patients scored 75 points or higher (72%), and 8 patients scored between 75 and 66 (28%), and one patient icd 2 weeks postoperatively.