1. The use of external fixators in the definitive stabilisation of the pelvis in polytrauma patients: Safety, efficacy and clinical outcomes.
- Author
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Tosounidis TH, Sheikh HQ, Kanakaris NK, and Giannoudis PV
- Subjects
- Abdominal Injuries complications, Abdominal Injuries diagnostic imaging, Adolescent, Adult, Aged, Aged, 80 and over, External Fixators, Female, Follow-Up Studies, Fracture Fixation methods, Fractures, Bone complications, Fractures, Bone diagnostic imaging, Fractures, Bone physiopathology, Humans, Incidence, Male, Middle Aged, Multiple Trauma complications, Multiple Trauma diagnostic imaging, Pelvic Bones diagnostic imaging, Pelvic Bones injuries, Postoperative Complications physiopathology, Radiography, Retrospective Studies, Treatment Outcome, United Kingdom, Young Adult, Abdominal Injuries surgery, Fracture Fixation instrumentation, Fractures, Bone surgery, Multiple Trauma surgery, Pelvic Bones surgery, Postoperative Complications surgery
- Abstract
Objectives: To analyse the complications and outcomes (functional/radiographic) of Pelvic External Fixators applied as part of the definitive fixation in polytrauma patients., Design: A single center retrospective chart review., Setting: A level-1 trauma center., Patients and Methods: We reviewed all the polytrauma patients (ISS>16) between 2007 and 2012 that had a PEF applied more than 30days. Complications including infection, aseptic loosening, neurological injury, loss of reduction, non-union and mal-union were recorded. Pelvic asymmetry and Deformity Index (DI) were measured at the immediate postoperative radiographs and final follow-up. The functional outcome at final follow up was estimated using a scale previously reported by Chiou et al., Results: 59 patients with mean age of 38.4 (16 - 81) years and mean ISS score 28 (16- 66) were included. The PEFs were applied for mean duration of 56 (30-104) days. The average follow-up was 403days. 22 injuries were type B and 37 type C (AO/OTA). The most common symptomatic complications were pin site infection in 11 (18.6%) and loosening in 5 (8.5%) cases. 44 (74.5%) patients had satisfactory functional outcome. The immediate post-operative and final asymmetry and DI were compared between the two pelvic injury groups (type B and C fractures). The difference in displacement progression was more for type C injuries (p=0.034) but no correlation to the functional outcome was evident., Conclusion: PEF can be used as definitive alternative stabilization method in specific situations at polytrauma setting. Radiological displacement occurred in both type B and C injuries but the clinical outcome was not correlated to this displacement. Complications related to PEF do not affect the final clinical outcome., Level of Evidence: Therapeutic Level III., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Published
- 2017
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