Combined pelvic ring and acetabular fractures - strategies and sequence of surgery. State of the art.

Combined injuries of the pelvic ring and the acetabulum are uncommon. Acute treatment should follow common protocols (ATLS e.g.) for pelvic ring injuries, although mechanical stabilization using pelvic binders or external fixators might be insufficient or even worsen the reduction in some combined fracture patterns. In case of mechanically connected acetabular and pelvic ring injury (MCAPI), surgical treatment might be demanding in lack of clear recommendations concerning the reduction and fixation sequence. A "pelvic ring first" sequence may be the best choice for most MCAPIs, starting with sacrum or SI-joint and symphysis pubis. An "acetabulum first" sequence should be considered in relatively stable posterior ring injuries and acetabulum fractures in younger patients, where a perfect anatomical reduction is feasible. Definitive surgical treatment should be performed as soon as possible depending on concomitant injuries, ideally within 3-7 days. Mechanical understanding of the combined fracture pattern and accurate planning are mandatory for surgical repair.
Competing Interests: Declarations Conflict of interest The authors declare that there are no conflicts of interest on this topic. Ethical approval This article does not contain any studies with human participants or animals performed by any of the authors. Conflict of interest and source of funding No author have to declare any conflicts of interest regarding this topic, no funding was received for this study, no existing proprietary interest.
(© 2024. The Author(s).)