Detroit Medical Center; 3990 John R Street, Harper 7-Brush, Detroit, MI 48201, USA.
Max Hospital Mohali, Phase 6 Mohali (PB), Chandigarh 160055, India.
Medicina (Kaunas). 2022 Aug 14;58(8):1098. doi: 10.3390/medicina58081098.
: Pelvic nonunion and malunion have been documented as rare complications in pelvic fractures and literature describing these topics is severely limited. Articles dedicated solely to pelvic malunion are nearly nonexistent. We conducted a literature search with the goal of providing a summary of the definition, causes, treatment strategies, and outcomes of pelvic malunion correction. : An initial review of the literature was performed using the PubMed, ScienceDirect, and Cochrane Database of Systematic Reviews databases. Search terms used were "malunion" AND "pelvic" OR "pelvis". Duplicate articles, non-English language articles without translations available and non-human subject studies were excluded. : Eleven original publications were found describing experiences with pelvic malunion. Seven of the articles were exclusively dedicated to the topic of pelvic fracture malunion, and only two reported on a series of patients treated for malunion with variably staged procedures. Most reports define pelvic pain as the main indication for surgical correction, along with gait disturbance, standing or sitting imbalance, and urinary or sexual dysfunction. Radiographically, vertical displacement of one to two centimeters and rotation of the hemipelvis of fifteen degrees or more have been described in defining malunion. No treatment algorithms exist, and each patient is treated with a unique work-up and operative plan due to the complexity of the problem. Only one series reported a patient satisfaction rate of 75% following malunion treatment. Conclusions: Pelvic malunion is a rare complication of pelvic ring injury and is seldom discussed in the literature. We found two small case series reporting exclusively on malunion treatment and complications. While some of the combination studies made the distinction in the diagnosis of malunion and nonunion, they rarely differentiated the treatment outcomes between the two categories. This paper describes pelvic malunion and highlights the need for more research into surgical outcomes of treatment specifically regarding functionality, patient satisfaction, and recurrence of preoperative symptoms.
: 骨盆不愈合和畸形愈合已被记录为骨盆骨折的罕见并发症，描述这些主题的文献极为有限。专门描述骨盆畸形愈合的文章几乎不存在。我们进行了文献检索，旨在总结骨盆畸形愈合的定义、原因、治疗策略和结果。 : 最初使用 PubMed、ScienceDirect 和 Cochrane 系统评价数据库对文献进行了回顾。使用的搜索词是“malunion”和“pelvic”或“pelvis”。排除了重复文章、无翻译的非英语文章和非人类研究。 : 发现了 11 篇原始出版物，描述了骨盆畸形愈合的经验。其中 7 篇文章专门讨论了骨盆骨折畸形愈合的问题，只有 2 篇报道了一系列接受分期手术治疗畸形愈合的患者。大多数报告将骨盆疼痛定义为手术矫正的主要指征，同时还有步态障碍、站立或坐立失衡以及尿失禁或性功能障碍。放射学上，垂直移位一到两厘米和半骨盆旋转十五度或以上已被描述为畸形愈合。由于问题的复杂性，不存在治疗算法，每个患者都采用独特的检查和手术计划进行治疗。只有一个系列报告了畸形愈合治疗后患者满意度为 75%。结论：骨盆畸形愈合是骨盆环损伤的罕见并发症，在文献中很少讨论。我们发现了两个专门报告畸形愈合治疗和并发症的小病例系列。虽然一些组合研究对畸形愈合和不愈合的诊断进行了区分，但它们很少区分这两种类型的治疗结果。本文描述了骨盆畸形愈合，并强调需要对治疗的手术结果进行更多研究，特别是关于功能、患者满意度和术前症状的复发。
