[Operation Via Anterior Approach in Treating Pelvic Crescent Fracture]

Objective: To evaluate the effectiveness of operation via anterior approach in treating pelvic crescent fracture.

Methods: Between June 2007 and December 2009, 18 patients with pelvic crescent fracture were treated, including 11 males and 7 females with an average age of 32 years (range, 19-52 years). The locations were the right in 8 cases and the left in 10 cases. Fractures were caused by traffic accident in 10 cases, by falling from height in 5 cases, and by crushing with heavy weights in 3 cases. All patients suffered lateral compression injuries of the pelvis. The mean time from injury to operation was 7.8 days (range, 3-22 days). The preoperative mean displacement of the posterior pelvic ring was 13.7 mm (range, 5-24 mm) according to the method described by Matta et al. The operation time, intraoperative blood loss, displacement correction of the posterior pelvic ring, fracture healing time, and Hannover pelvic score were recorded.

Results: The average operation time was 175 minutes (range, 110-230 minutes); the average intraoperative blood loss was 561.7 mL (range, 300-1,100 mL); the postoperative mean displacement of the posterior pelvic ring was 1.2 mm (range, 0-3 mm); and the mean displacement correction of the posterior pelvic ring was 12.6 mm (range, 4-23 mm). No intraoperative lumbosacral nervous injury occurred. Superficial wound infection occurred in 2 cases and was cured after 1 week of wound drainage and application of antibiotic. The others achieved healing of incision by first intention. Fifteen patients were followed up 16.1 months on average (range, 13-22 months). The X-ray films showed fracture healing in all patients. The fracture healing time was 3.6 months on average (range, 3-4 months). No patient had loss of reduction or failure of internal fixation. The clinical outcome was excellent in 10 cases (66.7%) and good in 5 cases (33.3%) according to Hannover pelvic score; social reintegration was complete in 13 cases (86.7%) and incomplete in 2 cases (13.3%).

Conclusion: Operation via anterior approach is a good choice in the treatment of pelvic crescent fracture.