Closed treatment of pelvic and lower extremity fractures.

Many of the advantages of operative fixation of pelvic and lower extremity fractures have been assumed rather than proved. This review illustrates how for some injuries, particularly for pelvic fractures, hip fractures in the senescent patient, distal femoral fractures, and tibial plateau fractures, operative treatment can increase the fracture disease. Because of its consistently high frequency of serious complications, operative treatment of pelvic fractures should still be considered experimental surgery. Despite impressive developments in diagnostic imaging, the axiom that we treat patients, not roentgenograms or computed tomograms still applies. To be effective, fracture treatment must be based on the comprehension of circumstances that indicate surgery as well as those that preclude surgery.