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Complex Fractures of the Limbs pp 37–50Cite as

Complex Fractures of the Pelvic Ring

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Abstract

Pelvic ring fractures are not frequent among the general population. But their incidence increased in cases of multiple-injured patients. Given the large number of blood vessels containing it is not difficult imagine that these fractures are associated with significant bleeding that may compromise the patient’s life. Very high-energy injuries can cause open fractures with vaginal or rectal tears. This situation worsens prognosis and increases the risk of infection.

Pelvic fractures that do not produce ring instability may be managed by conservative means. However, fractures affecting the ring stability should be treated by surgical stabilisation. Pelvic stabilisation may be done by external fixation as damage control surgery followed by ORIF as soon as possible. In stable patients with no other injuries, immediate ORIF may be done. Open pelvic fractures require special care. They must be managed by external fixation and treatment of the haemodynamic instability, followed by control of wounds, visceral tears and urologic injuries.

Complications of the pelvic ring fractures are frequent. Infection is rare in closed fractures, but it is frequent in open fractures. However, vein thrombosis in the lower limbs has a high incidence in both. Late complications include chronic pain, residual disability in physical functioning, incontinence, impotence and dyspareunia.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Paseo de la Castellana 261, Madrid, 28046, Spain

    Juan Carlos Rubio-Suárez

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  1. Juan Carlos Rubio-Suárez
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Correspondence to Juan Carlos Rubio-Suárez .

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Editors and Affiliations

  1. La Paz University Hospital, Madrid, Spain

    E. Carlos Rodríguez-Merchán

  2. La Paz University Hospital, Madrid, Spain

    Juan Carlos Rubio-Suárez

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Rubio-Suárez, J.C. (2014). Complex Fractures of the Pelvic Ring. In: Rodríguez-Merchán, E., Rubio-Suárez, J. (eds) Complex Fractures of the Limbs. Springer, Cham. https://doi.org/10.1007/978-3-319-04441-5_5

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  • DOI: https://doi.org/10.1007/978-3-319-04441-5_5

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