Pelvic post-traumatic asymmetry: Assessment and sequenced treatment

The most common cause of post-traumatic pelvic asymmetry is, by far, initial nonoperative treatment. Open reduction and internal fixation of unstable pelvic fractures are recommended to avoid pelvic nonunion or subsequent structural deformities. The most common symptom is pelvic pain. Pelvic instability is another symptom, as well as persistent urogenital problems and neurological sequelae. Preoperative evaluation of these patients requires careful clinical and functional assessment, in addition to a complete radiological study. Surgical treatment of pelvic fracture nonunions is technically demanding and has potentially serious complications. We have developed a new classification that modifies and completes Mears and Velyvis’s classification in which we highlight two types of post-traumatic sequelae with different clinical conditions and whose basic differentiating element is whether pelvic deformity is present or not. Based on this classification, we have established our strategy of surgical treatment. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170069.