Letter to the Editor regarding "Quantitative assessment of pelvic reduction using a pretensioned external fixator in unstable pelvic injuries: a retrospective study".

The pretensioned pelvic external fixator (PPEF) is a promising option for unstable pelvic injuries, but its radiological assessment remains unstandardized. Queipo-de-Llano et al. reported favorable reduction in 28 patients, with no significant difference between Tile C and A/B fractures. We highlight three methodological issues: inconsistent labeling of the Matta-Tornetta criteria, reduction CT performed several days after frame application, and inadequate control of baseline balance in subgroup comparisons. Clarifying these points is essential for interpreting the true efficacy of PPEF.