Treatment and outcomes of pelvic malunions and nonunions: a systematic review.

Abstract:

UNLABELLED:Although acute management of pelvic fractures and their long-term functional outcome have been widely documented, important information regarding malunion and nonunion of these fractures is sparse. Despite their relative rarity, malunions and nonunions cause disabling symptoms and have major socioeconomic implications. We analyzed the factors predisposing a pelvic injury to develop malunion/nonunion, the clinical presentation of these complications, and the efficacy of the reported operative protocols in 437 malunions/nonunions of 25 clinical studies. Treatment of these demanding complications appeared effective in the majority of the cases: overall union rates averaged 86.1%, pain relief as much as 93%, patient satisfaction 79%, and return to a preinjury level of activities 50%. Nevertheless, the patient should be informed about the incidence of perioperative complications, including neurologic injury (5.3%), symptomatic vein thrombosis (5.0%), pulmonary embolism (1.9%), and deep wound infection (1.6%). For a successful outcome, a thorough preoperative plan and methodical operative intervention are essential. In establishing effective evidence-based future clinical practice, the introduction of multicenter networks of pelvic trauma management appears a necessity. LEVEL OF EVIDENCE:Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

journal_name

Clin Orthop Relat Res

authors

Kanakaris NK,Angoules AG,Nikolaou VS,Kontakis G,Giannoudis PV

doi

10.1007/s11999-009-0712-2

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

2112-24

issue

8

eissn

0009-921X

issn

1528-1132

journal_volume

467

pub_type

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