Gautier E, Rommens P M, Matta J M
Department of Orthopaedic Surgery, University of Berne, Inselspital, Switzerland.
Injury. 1996;27 Suppl 2:B39-46.
Pelvic malunions or nonunions are the result of inappropriate treatment of rotationally or linearly unstable injuries of the pelvic ring. Long-term sequelae such as chronic pain in the posterior pelvic ring, gait abnormalities, leg length discrepancy, sitting discomfort, neurological problems or impingement on the visceral organs may be secondary to the disturbed integrity of the pelvic ring. The late correction of the deformity is technically much more demanding than the treatment of acute pelvic ring injuries. Depending on the specific problem, osteotomies at the site of the deformity, excision of scar tissue and callus, release of ligaments, bone grafting, and an adapted technique of reduction and fixation may be required. Possible complications include nerve or vascular injuries, incomplete reduction of the deformity, failure to unite, incomplete pain relief, and infection. Prior to surgery, a careful clinical and radiological examination is mandatory to assess the relationship between the presenting anatomical deformity and the complaints of the patient. The final decision for surgery has to be made by the patient taking into account reasonable expectation and the potential complications associated with the corrective procedure.
骨盆畸形愈合或不愈合是骨盆环旋转或线性不稳定损伤治疗不当的结果。骨盆后环慢性疼痛、步态异常、腿长差异、坐姿不适、神经问题或内脏器官受压等长期后遗症可能继发于骨盆环完整性受损。畸形的晚期矫正在技术上比急性骨盆环损伤的治疗要求高得多。根据具体问题，可能需要在畸形部位进行截骨、切除瘢痕组织和骨痂、松解韧带、植骨以及采用合适的复位和固定技术。可能的并发症包括神经或血管损伤、畸形复位不完全、不愈合、疼痛缓解不完全和感染。手术前，必须进行仔细的临床和影像学检查，以评估当前解剖畸形与患者主诉之间的关系。手术的最终决定必须由患者做出，同时要考虑到合理的预期以及与矫正手术相关的潜在并发症。
