FUNCTIONAL OUTCOME OF UNSTABLE PELVIC FRACTURES

Abstract

Globally, the major cause of morbidity and mortality in the younger age group is due to high- energy trauma. The connection suffer the loss of a young, active member of the population is recognizable of personal, social and economic losses to the family as well as to the nation. The mortality of major pelvic fractures without being affected by improvements in management is about 10%. Pelvic fractures constitute1- 3% in human body anatomically all skeletal injuries and about 2% of orthopaedic hospital admissions. The risk factors    associated with fractures of pelvis have been identified as the age of the patient, females, mode of injury and accidental crash (lateral impacts by a heavy vehicle). More likely to be involved in these accidents are Younger people.  Early death is usually due to sepsis, hemorrhage and multiple organ system failure about 40 to 50 % after these injuries. Many modalities of stabilization have been offered for pelvic fractures but the stabilization of pelvic fractures by external fixation has created large change in the management of trauma. External fixation plays not only part of revive but also dramatically altering the survival rate. Therefore many studies have claimed for good results in the functional aspect of external stabilization. Aim: The main aim of this study is to determine functional outcome and external fixation in the management of pelvic fractures. Material and method: This is a retrospective Study which is carried out in the department of orthopedics in Shri Vinoba Bhave Civil hospital, Silvassa. All patients with unstable pelvic facture who underwent surgical intervention and treated with external fixator were included in this study. Total 40 patients were included in this study with the age range from 20 years to 60 years. From all the patients for the records of data as documentation was collect by physical examination, past and present history and medical assistance and investigation such as Mode of Injury, surgery, radiographies and pattern of fracture were taken.  All the Cases were followed up periodically by clinical and radiological assessment during the study. Result: Total 40 patients were include in this study in which age of the patients range from 20 years to 60 years. Total there are 26 male and 14 female patients. All the patients with different type of pelvis facture were evaluated.  Among 40 patients, 14(35%) patients had type of injury, 16(40%) patients were in type B and 10(25%) patients were in type C. out of 40 patients, 12(30%) patients had Lower extremity fractures injuries while 9(22.5%) patients had Head injury of different levels of severity.  8(20%) patients had acetabulom fracture out of 40 patients and 7(17.5%) patients had upper extremity fractures and 3(7.5%) & 1(2.5%) patients had Urogenital injury & Urogenital injury respectively. Conclusion: Major cause for mortality and morbidity is a pelvis Fracture and that can be decreases by External stabilization with external fixator. Pelvis fracture associated injuries are common and often have substantial effect on the patient’s psychological status and rehabilitation period is prolonged.  Therefore, proper management relent outcome is satisfactory. Hence, combination of external fixator and internal fixation was necessary in unstable pelvic as compared with stable or partially stable pelvic fracture.

Keywords: Pelvis, Fracture, External fixator, clinical outcome