SURGICAL TREATMENT OF OLD PELVIC INJURIES

Abstract

The authors of the article carried out a retrospective analysis of the case histories of 43 patients (age from 20 to 66 years) with chronic pelvic injuries, hospitalized in 2010-2019. The damage type was assessed according to the AO classification. At the previous stages of treatment, conservative stabilization of the pelvis was used - 12 (27.9%) patients, external fixation - 21 (48.8%) and unsuccessful internal fixation - 10 (23.3%) cases. Patients were divided into two groups: I - 34 (79.1%) cases with unconsolidated or incorrectly consolidating lesions, which underwent reconstruction of chronic lesions within from 3 weeks to 4 months; II - 9 (20.9%) people with pseudoarthrosis or consolidated with significant deformity, later than 4 months. To determine the type of injury and preoperative planning, clinical and radiological diagnostics, as well as computed tomography, were used. The residual postoperative displacement was assessed according to the Pohlemann classification. To analyze long-term results, the Majeet system of functional assessment of pelvic fractures was used. During surgery, anatomical reduction was achieved in 30 (69.8%) patients, satisfactory - in 8 (18.6%), insufficient reduction more than 10 mm - in 5 (11.6%). Intraoperative bleeding occurred in 5 (11.6%) cases. In the early postoperative period 1 (2.3%) patients died. Postoperative wound inflammation requiring revision occurred in 9 (20.9%) cases. Loss of reduction followed by reosteosynthesis in 4 (9.3%) patients. The performed surgical treatment of chronic pelvic fractures made it possible to achieve excellent and good results in 56.4% of cases; improve the qualitative assessment of health by 74.4% and increase the functional assessment by 24 - 46 points from the initial one.