• Marieke J Witvliet, P H Ping Fung Kon Jin, Johan Carel Goslings, Jan S Luitse, and Kees-Jan Ponsen.
• Trauma Unit Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. k.j.ponsen@amc.uva.nl.
• Eur J Trauma Emerg S. 2009 Feb 1;35(1):43-8.

BackgroundSince the Academic Medical Center Amsterdam was appointed as a level-1 trauma center in July 1997, the number of polytrauma patients who were presented has increased. This stimulated us to perform a retrospective analysis on the treatment results of patients with a pelvic ring fracture and to evaluate our treatment strategies.Materials And MethodsA chart review of all patients with a partially stable fracture (Tile/AO type B) or an unstable fracture (Tile/AO type C) was performed. All patients presented between 1 January 1990 and 31 December 2001 were included. Two historical groups (1990-1997 and 1998-2001) were formed. General demographics, treatment method, complications, re-operations, length of hospital stay and anatomic results were recorded for all patients.ResultsFifty-two patients were included in group 1 and 65 patients in group 2. There was a lower mortality in group 2. The B-fractures were treated either conservatively (group 1 83.3% vs. group 2 73.8%), by external fixation (16.7 vs. 9.5%) or by ORIF (0 vs. 16.7%). C-fractures were treated by ORIF in 32.1 versus 82.6%, by external fixation in 28.6 versus 4.4% and conservatively 39.3 versus 13.0%, respectively. Fracture healing with less than 10 mm displacement was achieved in 58.3 versus 78.6% for the B-fractures, while this was achieved in 42.9 versus 73.9% in the C-fractures. Group 2 showed significantly fewer complications.ConclusionEvaluating two consecutive patient groups shows an increase in the number of fractures. A more aggressive surgical treatment has lead to lower mortality, improved anatomical reduction, and lower rate of complications.

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