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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Treatment and outcomes of pelvic malunions and nonunions: a systematic review

Review published: 2009.

Bibliographic details: Kanakaris NK, Angoules AG, Nikolaou VS, Kontakis G, Giannoudis PV.  Treatment and outcomes of pelvic malunions and nonunions: a systematic review. Clinical Orthopaedics and Related Research 2009; 467(8): 2112-2124. [PMC free article: PMC2706342] [PubMed: 19184260]

Quality assessment

This review assessed the effectiveness of treatment of pelvic malunion and nonunion in terms of overall union rates, pain relief, patient satisfaction and return to pre-injury level of activities. The authors concluded that treatment of pelvic malunion and nonunion appeared effective in most cases, but there were some perioperative complications. These conclusions seem reasonable. Full critical summary


Although acute management of pelvic fractures and their long-term functional outcome have been widely documented, important information regarding malunion and nonunion of these fractures is sparse. Despite their relative rarity, malunions and nonunions cause disabling symptoms and have major socioeconomic implications. We analyzed the factors predisposing a pelvic injury to develop malunion/nonunion, the clinical presentation of these complications, and the efficacy of the reported operative protocols in 437 malunions/nonunions of 25 clinical studies. Treatment of these demanding complications appeared effective in the majority of the cases: overall union rates averaged 86.1%, pain relief as much as 93%, patient satisfaction 79%, and return to a preinjury level of activities 50%. Nevertheless, the patient should be informed about the incidence of perioperative complications, including neurologic injury (5.3%), symptomatic vein thrombosis (5.0%), pulmonary embolism (1.9%), and deep wound infection (1.6%). For a successful outcome, a thorough preoperative plan and methodical operative intervention are essential. In establishing effective evidence-based future clinical practice, the introduction of multicenter networks of pelvic trauma management appears a necessity. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2012 University of York.

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