[Unstable fractures of the pelvis treated by Ilizarov external fixation device].

We reviewed seven patients with an unstable fracture of the pelvic ring who had been treated with a Ilizarov external fixation device after a mean follow-up of 5.5 years. There were four "open-book" injuries (type B according to Tile) and three rotationally and vertically unstable injuries (type C according to Tile). In all patients union of fracture site had been achieved after a mean period of 65 days in patients with type B injuries and 98 days in patients with type C injuries. In the four patients with an "open-book" injury the symphyseal diastasis was partially reduced from 46 mm to 13 24mm to 13mm. The radiological result was excellent in one patient, good in one and poor in two patients. The functional outcome was rated as excellent in three patients and good in one patient. In patients with type C injury vertical displacement was partially reduced from 21mm to 12mm. The patients in this group had excellent, good and poor radiological result, respectively. The functional outcome was excellent in two cases and good in one case. General surgical complications were not seen. Infection at the pin sites was seen in six patients. In our study unsatisfactory or poor functional result was not registrated due to construction characteristics of Ilizarov device. Because of this characteristics there were no residual vertical displacement more then 8 mm.

[Nonunion--pseudoarthrosis of the scaphoid bone treated with percutaneous fixation, with compression and distraction].

Fractures, and especially pseudoarthroses of the scaphoid bone, are a great problem in orthopedic surgery, because the failure percentage is remarkably high (20-30%) even with the top modem treatment methods. Use of grafts, especially well-vascularized ones, along with good fixation, has improved treatment outcomes, but the failure and complication percentages remain high. In the pilot study, we present the first five patients with the pseudoarthrosis of the scaphoid bone, male, of 26.8 years of average age (from 22 to 34-years-old), in whom the method of extrafocal fixation, with distraction and compression, was applied. The fracture healing was achieved in all patients after an average period of 87 days (from 60 to 100 days), with the healing time also including a minimum of a month of physical therapy, after the fixator was removed. The result was evaluated using the Mayo wrist score, and from the preoperative 26 points, 82 points were achieved.