The use of a biplanar construct in pelvic external fixation.

Abstract

Inserting pins at a single location of the iliac crest temporarily provides an effective splint for emergency patients with pelvic ring fractures. For a longer application, however, this procedure frequently causes infection and pin loosening and does not effectively stabilize the pelvic construct. We presumed biplanar pelvic constructs may provide better stability than a uniplanar construct. Two patients were treated with inserting pins at the lateral side of the supra-acetabulum as well as the iliac crest. Postoperatively, they demonstrated significant improvement in pain relief. The biplanar pelvic constructs showed sufficient stability during the procedure and at the time of pin removal several months postoperatively. Another pinning location for pelvic external fixation is the anteroinferior iliac spine toward the posteroinferior iliac spine. Inserting pins from this spot and the iliac crest does not create a biplanar construct, since anatomically these pins share a similar plane. Thus, the biplanar method in which pins were introduced at the lateral side of the supra-acetabulum and at the iliac crest was selected. Despite the pins' application for several months, pin-site infection was not critical in our cases. We concluded that stability of the biplanar construct helped minimize pin-site infection.