Pelvic Ring Disruption — Malalignment 16

Optimal initial care can reduce the occurrence of pelvic ring malreductions; however, nonunions and malunions may still occur.1-4 Tile5 estimated a 5% incidence of residual severe deformity in major disruptions of the pelvic ring. However, nonoperative management of vertically unstable pelvic ring injuries can lead to malunion and/or nonunion in 55% to 75% of cases.4,6 The factors that lead to malreduction of pelvic ring disruptions include injury factors, surgeon factors, and patient factors. Pelvic malunions often present with pain posteriorly,7 but can also present with neurologic, gynecologic, or urologic problems. Additional presentations include imbalance during sitting, lying, or standing (Table 16-1).