PURPOSE To analyze the clinical and radiological results of the different fixation methods according to the type and displacement of unstable pelvic ring injuries. MATERIALS AND METHODS Twenty-three patients with unstable pelvic ring injuries from January 2005 to December 2009 were classified according to the AO/OTA classification system. When patients had been diagnosed with unstable pelvic ring injuries with partial instability, they were treated by anterior fixation with a plate and posterior percutaneous iliosacral screw fixation. When patients had been diagnosed with unstable pelvic ring injuries with complete instability, they were treated by open reduction and anterior to posterior fixation with a plate through the ilioinguinal approach. The radiological results were evaluated using Matta and Saucedo's method, and the clinical results were evaluated using Rommens and Hessmann's method. RESULTS The outcomes from the radiological evaluation were that the displacement of the posterior pelvic ring were improved by about 6.65 mm in unstable pelvic ring injuries with partial instability. The displacement of the posterior pelvic ring were improved by about 7.8 mm in unstable pelvic ring injuries with complete instability. The clinical results were excellent in 13 cases and good in 6 cases on latest follow-up. CONCLUSION Good results can be achieved by selecting the treatment method according to the type of unstable pelvic ring injurie and displacement.
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PURPOSE To evaluate the postoperative progress and outcomes of bone injured patients with long bone fracture showing callus formation and deformity due to delayed surgical treatment. MATERIALS AND METHODS 10 cases with more than 1 year follow up were chosen from 12 patients with long bone fracture whose surgical treatment was delayed due to brain injury. Exuberant callus formation and deformations were observed. Average delayed period was 6.7 weeks (4~10 weeks). Preoperative callus formation, shortening and angulation were evaluated using plain radiographs. Total operation time and transfusion amount were compared with that from operations done within 2 weeks following accident. Postoperative bone union was checked. RESULTS In all cases, preformed angulation and hypertrophic ossification made reduction difficult and this increased total operation time and transfusion amount but had no statistical importance. In patients with humerus and femur fractures accompanying brain injury, massive hypertrophic ossification was observed both in preoperative period and in postoperative period. Average bone union period was 13.5 weeks in humerus fractures, 17.9 weeks in femur fractures. The bone union period was shorter in subject group but had no statistical importance. CONCLUSION Early surgical treatment is essential to patients with long bone fracture accompanying brain injury but if early surgical treatment can not be done, proper immobilization to fracture site should be done.
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