A prospective cross-sectional study of the outcome of definitive skeletal stabilization of unstable pelvic fractures using external fixators in a limited resource setting: Need for thorough improvements to meet the standards

Background

The anterior pelvic external fixator is widely used in the emergency management of unstable pelvic fractures. Management of pelvic ring injuries is difficult in limited resource settings where the diagnostic and therapeutic means required for intervention are not readily available. We aimed to identify the therapeutic challenges and to evaluate the outcome of unstable pelvic fractures managed definitively by external fixation in an environment with limited human, technical, and financial resources.

Patients and methods

A hospital-based prospective observational and cross-sectional study carried out from the 1st of January 2016 to the 31st of December 2021 ​at the Limbe Regional Hospital, a regional referral hospital that serves as a teaching hospital for the Faculty of Health Sciences of the University of Buea.

Results

A total of 45 patients were included in the study. The indications of maintaining the pelvic external fixators as definitive treatment were financial constraints and inadequate technical resources needed for surgery in almost half of the cases. The overall average functional outcome in this study was fair. Good to excellent scores were recorded in only one-quarter of the cases.

Conclusion

Definitive pelvic external fixation of unstable pelvic fractures in resource-limited settings needs thorough improvements to meet the standards as the outcome was fair in half of the cases, and good to excellent in only 25% of the cases. Locally available human, technical and financial resources should be considered in the decision to perform definitive pelvic external fixation as an alternative to internal fixation of unstable pelvic fractures.