Osteoplastic correction of the pelvic ring in old injuries of the sacroiliac and pubic joints aggravated by a large divergence of the pubic symphysis.

Abstract

Surgery to treat old injuries of the pelvis was performed to reconstruct the pelvic ring (its anterior and posterior compartments) using autoplastic materials and various fixators. The reconstructive operation for extensive disjunction of the pubic symphysis and sacroiliac joint is performed in three stages. The first stage is to attain the greatest possible elimination of complete dislocation of the pelvis, producing a closer apposition of pubic bones, with the aid of an external pivotal fixator. The second stage of the surgical restoration of the structure is aimed at stabilization of the posterior elements, which bear the main static load; for this purpose, arthrodesis of the sacroiliac joint is performed. In the third stage, bone is transplanted for fusion of the anterior elements of the pelvic ring. Fifty-seven operations were performed on 23 patients. Good results were observed in all of the patients. One group (13 of 23) returned to their previous activities; this alone is evidence of the value of the multistage method of surgical reconstruction of the pelvic ring for treatment of chronic injuries.