Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2010; 77(6):450-456 | DOI: 10.55095/achot2010/075

Changes in Epidemiology and Treatment of Pelvic Ring Fractures in Germany: An Analysis on Data of German Pelvic Multicenter Study Groups I and III (DGU/AO)Current concepts review

G. TOSOUNIDIS^1,*, J. H. HOLSTEIN¹, U. CULEMANN¹, F. HOLMENSCHLAGER², F. STUBY⁴, T. POHLEMANN¹, R. Kurowski¹, P. Garcia¹, G. Streicher³, H. Schmal⁵, A. Pizanis¹

¹ Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany

² Department of Trauma Surgery, University of Magdeburg, Germany

³ Department of Trauma and Orthopaedic Surgery, Municipal Hospital, Braunschweig, Germany

⁴ BG Trauma Centrer Tübingen, Germany

⁵ Department of Trauma and Orthopaedic Surgery, University of Freiburg, Germany

The diagnosis and treatment of pelvic ring injuries is demanding. Therefore, standardized classifications characterizing the stability and severity of pelvic ring fractures are essential to define clear algorisms for the treatment of these injuries. The first part of this article provides an overview of the etiology and classification of pelvic ring injuries. We recommend the AO classification to assess the stability of pelvic ring fractures. This classification includes 3 types of pelvic ring fractures: stable fractures (type A), fractures with only rotational instability (type B), and fractures with complete (rotational and translational) instability. To describe the severity of the injury, pelvic ring fractures can be classified as plain pelvic fractures, which include fractures with osteoligamentous instability, but without significant concomitant injuries to the soft tissue, versus complex pelvic fractures, which are combined with severe peripelvic soft tissue lesions. While plain pelvic fractures allow thorough clinical and radiological diagnostics, complex pelvic traumata represent a life threatening situation for the patient, which needs immediate emergency measures.
In the second part of the this review we present current data of the German Pelvic Multicenter Study III (DGU/AO) on the epidemiology and treatment of pelvic ring injuries deriving from a study population of more than 3000 patients. In addition, we compare the present data with those of the German Pelvic Multicenter Study I and highlight changes in the epidemiology and treatment of pelvic ring fractures during the past decades. Taken together, we could observe an increasing number of elderly patients sustaining pelvic ring fractures. Regarding the treatment of pelvic ring fractures we found a rising use of external fixators and SI screws, while the number of laparotomies has markedly decreased.

Published: December 1, 2010  Show citation