الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
A pelvic ring disruption is defined as any injury to the bony or supporting ligamentous structures of the pelvis. A spectrum of damage can result depending on a number of factors, including the magnitude, direction, and location of the injuring force. Furthermore, as the pelvis is a ring structure, an injury to the one area of the pelvis cannot occur in isolation, but must be accompanied by a second injury elsewhere in the ring. Based on these factors and the fundamental anatomy of the pelvis, injury classification systems have been developed to sort disruptions of the pelvic ring in a useful way.
Reduction of pelvic ring deformities can be accomplished using closed or open techniques. Closed reduction and percutaneous fixation can be performed urgently, even during the initial resuscitation of the patient, thereby diminishing pelvic bleeding. Stable percutaneous pelvic fixation also decreases operative blood loss and time, is associated with a very low wound complication rate, and allows comfortable mobilization of the patient. An additional benefit was that these percutaneous techniques did not decompress the pelvic hematoma, allowing early definitive fixation without the risk of additional hemorrhage.
Early and accurate closed reduction in conjunction with stable fixation using percutaneous insertion techniques could be ideal treatment for certain pelvic ring disruptions, especially in patients with polytrauma.
This was a prospective study of twenty patients with unstable posterior pelvic ring injuries Tile type C (completely unstable). All cases were treated in Menoufia University, Tanta University and Al Qasr El Aini Hospitals during the period from March 2019 to september 2020. method of fixation was percutaneous iliosacral screw after closed reduction. Implants used were large set cannulated screws. The age of the patients ranged from 20 – 50 years with a mean age (32.01 years) there were 12 males and 8 females. The left side was affected in 8 patients and the right side in 12 patients.
It was found that unstable pelvic ring injuries were more common in males than females, affect active adult age group than elderly and motor car accidents were the most common causative trauma in both groups of patients to a similar degree.
In this study, intraoperative blood loss was minimal. no blood transfusion was needed with hemoglobin concentration of more than 10 mg/dl postoperatively.
Operative time and hospital stay were short. Also healing duration was significantly short.
For most cases, partial weight-bearing was started after 4-6 weeks and progressed gradually to full weight-bearing after 8-10 weeks guided clinically and by radiological healing. The clinical results were assessed by Lindahl et al.’s modification of the Majeed score and radiological evaluation was according to the maximal residual displacement reached at the end of the follow up periods of each patient by way of constructing horizontal reference lines through bony landmarks.
The radiological outcome was satisfactory in about 80% and functional results were satisfactory in about 76%.
It was found that better reduction of posterior pelvic ring injuries was associated with better final outcome, better postoperative function, less pain and better return to previous job. Postoperative residual posterior displacement of more than 1 cm was associated with increased long-term pain and disability. Statistical analysis showed significant relation between radiological and clinical results that means satisfactory reduction of posterior pelvic ring injuries was associated with satisfactory clinical results.