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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 9,
1201-1207.
doi: 10.1302/0301-620X.91B9.22093 Copyright © 2009 by British Editorial Society of Bone and Joint Surgery Early experience with reduction of displaced disruption of the pelvic ring using a pelvic reduction frameK. A. Lefaivre, MD, MSc, FRCSC, Assistant Professor, Orthopaedic Surgeon1; A. J. Starr, MD, Associate Professor, Orthopaedic Surgeon2; B. P. Barker, MD, Orthopaedic Surgeon3; S. Overturf, MD, Resident2; and C. M. Reinert, MD, Professor, Orthopaedic Surgeon2
1 Department of Orthopaedic Surgery, University of British Columbia, VGH Research Pavilion, 110-828, West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L8. Correspondence should be sent to Dr K. A. Lefaivre; e-mail: kellylefaivre{at}hotmail.com
We describe our early operative experience with a new pelvic reduction frame and the standard of reduction of fractures of the pelvic ring which we achieved in the first 35 consecutive patients, with 34 acute fractures and one nonunion. The pre-operative and immediate post-operative radiographs were measured, using two methods, to find the maximum radiological displacement of the fracture and the quality of the reduction according to the criteria of Tornetta and Matta. There were 19 vertical shear fractures and 16 compression injuries. The mean age of the patients was 33.5 years (10 to 59) and mean delay to surgery was 4.6 days (0 to 16) in the 34 acute injuries. The mean operative time in isolated procedures was 103.4 minutes (SD 6.5). All but one patient had iliosacral screws implanted, 18 had screws in the anterior column, six had plates at the symphysis pubis and 12 had anterior external fixators. The mean maximum horizontal or vertical displacement was improved from 30.8 mm (SD 2.7) to a mean of 7.1 mm (SD 0.7). The reduction was assessed as excellent in ten patients, good in 18, and fair in the remainder. There was no significant influence on the quality of the reduction caused by obesity (p = 0.34), the type of fracture (p = 0.41) or delay to surgery (p = 0.83). The frame was shown to be effective, allowing the surgeon to obtain a satisfactory reduction and fixation of acute displaced disruptions of the pelvic ring.
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