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Aim To propose a new prognostic classification system for pelvic injuries based on a new detailed and all-encompassing evaluation of the injury pelvic outcome score and to check the prognostic value of this classification and evaluate its reliability and reproducibility. Methods From January 2017 to June 2020 from 156 pelvic fractures treated at our hospitals, 98 patients with pelvic fractures were recruited according to inclusion and exclusion criteria. All patients compiled three scores (New Score System, Majeed Score, SF-12) sessions two times during the hospital stay to evaluate the endpoint before the trauma and two years after the trauma. All patients carried out three tests independently. The evaluation of three scores included a pelvic and general complication after the surgery, the times needed to compile three score system. For reliability of the new score systems we evaluated the inter-observer or intraobserver agreement, the prediction strength of each score, and a prognostic value. Results A total of 98 patients were enrolled (74 were males and 24 females) with mean age of 43.6 (±18.6) (range 16-75) years. Tau B Kendall value was 0.827 for the new score system, 0.673 for the Majeed score, 0.746 for SF-12, there was p0.05 for the new score system. Conclusion The new score system is prognostic, reliable, reproducible and can become a useful instrument to adequately correlate the long-term outcomes of pelvic injury fractures. Also, it provides a better evaluation of pain, work, sexual possibilities and satisfaction, balance-sitting-walking and psychological status.

Aim To report our indications and limitations about the use of external fixation in children. Methods It was retrospectively reviewed all tibial fractures treated with monolateral and hybrid external fixator, at our three Centres. It was included 32 fractures which did not show an acceptable reduction after an attempt under anaesthesia. The exclusion criteria were: open fractures, children with previous fractures of the lower limbs, with skeletal congenital diseases, fractures involving the physis and with neurovascular involvement. All fractures were classified according to the AO (Arbeitsgemeinschaft für Osteosynthesefragen) classification. An outcome was evaluated according to the time needed to obtain radiographic bone healing, the range of motion (ROM) of the ankle, the asymmetry of the lower limbs, the malunion, and complications. Results The average time of consolidation was 10.66 weeks (6-17 weeks). There were no cases of deep infection, but only seven cases of superficial pin infections. No patients reported loss of ROM of the knee or ankle. We had zero cases of residual angle greater than 5°, and in all cases the difference in length between the limbs was1 cm. Conclusion The external fixation is a viable technique in the treatment of tibial fractures in children. Therefore, the external fixation, both monolateral and hybrid, should be considered a viable treatment for this type of fracture.