External fixation of unstable pelvic fractures: experiences in 22 patients treated with a trapezoid compression frame.

Biomechanical experiments have shown high stability and load acceptance of the pelvis if the external device is mounted as a trapezoid compression frame. Clinical results in 22 patients with double vertical pelvic fractures illustrate the reduction of displaced pelvic fractures and the mounting of the frame. Reduction is obtained under general anesthesia within two days of the trauma. The external compression frame affords noteworthy relief of pain in all patients and greatly facilitates nursing. The patients were verticalized three weeks later and the frame removed six weeks after its applcation. There was one death. The early stabilization of the pelvis and consequently controlled hemorrhage may have contributed to the low mortality. At follow-up, the radiographic result was graded as excellent in 15 cases, good in four cases and poor in two cases. Impaired gait was recorded in two patients and persistent low back pain in one. The trapezoid compression frame is applied as soon as possible after admission of all patients with severely unstable pelvic fractures.