ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026
Quantitative assessment of pelvic reduction using a pretensioned external fixator in unstable pelvic injuries: a retrospective study.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionConventional anterior external fixation provides effective stabilization in pelvic injuries but has limited ability to reduce and control posterior pelvic ring displacement, particularly in type C fractures. Although several anterior fixation systems capable of posterior compression have been described, many remain complex and impractical in emergency settings. PURPOSE: To evaluate the effectiveness of a pretensioned pelvic external fixator (PPEF) as a reduction tool in unstable pelvic fractures across different clinical scenarios.
methodsA retrospective study was conducted including 28 patients treated with PPEF between 2012 and 2024. In 24 cases, the device was used as emergency stabilization, and in 4 cases as an adjunct or intraoperative reduction tool. Pelvic reduction was assessed using pre- and postoperative CT scans. Anterior and posterior diastasis, as well as vertical displacement, were measured. Radiological outcomes were classified using Matta/Tornetta criteria. Subgroup analyses were performed according to fracture type (A/B vs C), presence of sacral or pubic fractures, and bilateral involvement.
resultsPosterior diastasis decreased from 2.54 ± 2.09 cm preoperatively to 0.30 ± 0.67 cm postoperatively. Anterior diastasis improved from 2.54 ± 3.00 cm to 0.35 ± 0.51 cm. Vertical displacement was reduced from 1.18 ± 0.95 cm to 0.36 ± 0.52 cm. Excellent or good radiological outcomes were achieved in 89.3% of cases. No significant differences were observed between fracture types or injury patterns. The complication rate was low, with pin site infection in 7.1% of cases (n = 2) and no observed re-displacement.
conclusionThe pretensioned pelvic external fixator is a simple and effective technique for achieving immediate radiological reduction in unstable pelvic injuries. It provides reliable correction of displacement, including in type C fractures, and may serve as a valuable tool in both emergency management and as an adjunct to definitive fixation, particularly in resource-limited settings. LEVEL OF EVIDENCE IV: Retrospective study.
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