الفهرس 
Surgical anatomy & BiomechanicsOnly 14 pages are availabe for public view
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Abstract
Despite the introduction of organized trauma system, pelvic ring disruption continues to be a significant source of morbidity and mortality ranging from 4.8 to 50% in open fractures. (1) For those trauma patients who survive, pelvic ring disruption is a significant cause of permanent disability. (2)
Pelvic ring fractures are usually secondary to high-energy trauma such as fall from a height, crushing injuries, and motor vehicle crashes with the latter being the commonest mechanism of injury. (3) The acute management of pelvic ring fractures in polytraumatized patients often requires a multidisciplinary approach involving a variety of specialties, (4) as the high-energy force applied to the pelvic ring is also distributed to the other parts of the skeleton and may result in injuries to soft tissues, neural elements, major blood vessels and often urological, or bowel injuries and fractures to other parts...etc. (5)
Definitive stabilisation of the pelvic ring disruption remains a challenge to the orthopaedic surgeon. Biomechanical studies have shown that anterior external fixation, useful in the acute situation to reduce pelvic volume and control haemorrhage, cannot stabilize the posterior lesion in an unstable type C pelvic disruption. (5) Several studies have found internal fixation to be superior to both external fixation.
Classical techniques of internal fixation have traditionally required extensive surgical exposure of the deep structures of the pelvis, which can be associated with problems of wound healing, damage to major vessels or nerves and an incidence of infection of up to 25%. Most of these complications are related to the surgical exposure itself, rather than to the initial injury. It therefore seems reasonable to consider less invasive alternatives. In an attempt to overcome the morbidity of extensile surgical approaches, percutaneous fixation of the pelvis has been receiving increasing attention.
The Percutaneous techniques were introduced with the aim of decreasing morbidity and mortality to the patient while maintaining a rigid and anatomic reduction. Intraoperative assessment of fracture reduction and percutaneous insertion of screws has become possible with improvements of imaging technology and an improved understanding of complex pelvic anatomy.