Complications and late therapeutic results of conservatively managed, unstable pelvic ring disruptions

Fifteen patients admitted with unstable (type III) pelvic ring disruptions were analysed. Most injuries involved traffic accidents (73%); all 15 patients sustained additional injuries (ISS ranged from 16-57, mean 30.6). Six patients were polytraumatized (ISS 29-57, mean 41.2). The conservative treatment consisted of suspension in a pelvic sling with or without skeletal traction during 4-9 weeks. There was no mortality (patients who had died within 24 hours after admittance, had been excluded). Complications were seen in one patient who developed decubitus ulcers and one patient with persistent separation at the symphysis, ultimately requiring operative treatment. All patients were discharged with full or partial weight bearing. Twelve patients were available for follow-up 2-26 years after injury. Eight patients were asymptomatic, three complained of a residual low back pain. A leg length discrepancy was found in four patients (1-2.5 cm). Roentgen films showed restoration of the pelvic ring in all cases. The results suggest a more favourable perspective of the conservative management of pelvic ring disruptions than generally assumed