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Internal fixation of pelvic injuries

The essence of management of pelvic fractures, a high energy injury, is multidisciplinary approach, wherein, the primary goal of treatment is hemodynamic stability. Restoration of a stable pelvic ring which allows optimum weight transmission to the limbs is the ultimate aim of any surgical procedure. Contradicting schools of thought exist between whether to fix the anterior pelvic ring first vis-a-vis the posterior ring. To some extent, the decision is guided by the operating surgeon′s preference for percutaneous fixation as opposed to conventional open surgery. Anatomic reduction of the fracture remains an important goal, whether performed open or closed, as residual displacement is associated with poorer outcomes. A comprehensive literature search was conducted using the Ovid interface; 1232 English language citations relating to management of pelvic fractures were screened, out of which 34 articles were perused for surgical treatment of pelvic fractures and 21 of the above, specifically dealing with the principles and techniques and biomechanics of internal fixation of the disrupted pelvic ring, formed the basis of the present narrative.