Surgical treatment of chronic vertically unstable pelvic ring injuries

BACKGROUND: The initial severity of patients with vertically unstable pelvic injuries often does not allow to perform timely reconstructive surgical intervention. Thus, the number of chronic injuries increases. Treatment of patients with long-term pelvic ring damage (after 3 weeks from injury) with significant vertical displacement (over 20 mm) is a problem of its own.

AIM: To analyze the immediate and long-term results obtained in patients with unresectable and chronic vertical unstable pelvic ring injuries.

MATERIALS AND METHODS: The results for 58 patients treated at the Priorov National Medical Research Center with chronic vertically unstable damage to the pelvic ring in the period from 2017 to 2022 were analyzed. Clinical and radiological diagnostic methods, as well as the Majeed questionnaire, were used to assess the treatment results.

RESULTS: The follow-up period for the patients ranged from 1 to 3 years (2.1 years on average). All patients after surgical treatment showed pain syndrome regression in the posterior pelvic area, decreased pain in sitting and standing positions, which improved their quality of life. All patients were able to move independently, to self-care after the treatment. Excellent results according to Majeed questionnaire one year after surgery were achieved in 4 (8.2%) patients, good — in 40 (81.6%), acceptable — in 5 (10.2%), there were no unsatisfactory results.

CONCLUSION: The vertebral-pelvic fixation technique allows specialists to effectively treat long-standing vertically pelvic ring unstable injuries and perform one-stage repositioning and stable fixation of the posterior pelvic ring.