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Management of traumatic pelvic ring fractures may reduce incidence of severe complications

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BERLIN — Careful, yet immediate surgical planning proved critical in the clinical management of open blast pelvic trauma and other injuries associated with explosions in a war setting, according to a study from U.K. researchers presented at the 13th EFORT 2012 Congress.

Management of initial pelvic stabilization, deciding between external or internal fixation, and working to divert fecal matter away from the surgical site can reduce infection and improve fracture stability, according to the abstract. Patients had vascular or genital injuries and many patients had bladder bowel injuries.

Scott Evans

“We have done the first study ever to evaluate the…pattern [and] management…required to look after these individuals, paying particularly close attention to [whether] fecal diversion really reduces the rate of infection and…complications from internal fixation,” Scott Evans, an orthopaedic registrar at the National Health Services in Birmingham, United Kingdom, said here.

Of the patients managed with external fixation, 57% required removal of metal and 31% required fecal diversion for infection prevention.

Patients had clinical and radiological signs of pelvic stability in 90% of cases at 20.3 months follow-up and 83% of patients could ambulate at the same follow-up time point. Investigators reported a mean operative time of 29.6 hours and an average length of hospital stay of 70.2 days.

Reference:

• Evans S, Ramasamy, A. The open blast pelvis: the burden of management. Paper #12-1138. Presented at the 13th EFORT Congress 2012. May 23-25. Berlin.
• Disclosure: Evans has no relevant financial disclosures.