External fixation for pelvic ring disruptions

The application of external fixation for acute treatment of unstable pelvic fractures can be a lifesaving procedure; however, it must be coordinated with other efforts of the trauma team. The patient with a pelvic fracture must be adequately resuscitated and carefully evaluated. This evaluation includes a careful physical examination and radiographic studies, which include plain films and computerized tomography. A proper evaluation enables classification of the pelvic injury and appropriate selection of patients that require acute pelvic external fixation. In this article, both open and percutaneous techniques for pin placement and fixator frame configurations are discussed.