Pelvic Fractures (Subscribe)  

The pelvis is a ring-like structure of bones at the lower end of the trunk. The two sides of the pelvis are actually three bones (ilium, ischium, and pubis) that grow together as people age. Strong connective tissues (ligaments) join the pelvis to the large triangular bone (sacrum) at the... Highly Reputable

Limited access version of Tile, Helfet & Kelham's comprehensive textbook

The iliofemoral approach and the approach named after Smith-Peterson share a similar skin incision but differ markedly in the deep exposure provided.
Access - This approach provides access to the iliac crest and the entire internal iliac fossa. The fossa exposure incorporates full visualization of the anterior aspect of the sacroiliac joint,...

The ilioinguinal approach was developed by Emile Letournel based on cadaveric dissections to provide anterior access for fractures of the acetabulum. It provides exposure of the inner aspect of the innominate bone from the sacroiliac joint to the pubic symphysis. The surgical exposure requires development of three wound intervals. Mobilization of the...

The Kocher-Langenbeck approach is a nonextensile approach to the posterior acetabular column.
It allows direct visualization of the dorsocranial part of the acetabulum either through the fracture gap or after capsulotomy.

two vertical fractures involving one side of the pelvic ring
* one fracture anterior to the acetabulum
o usually through the pubic ramus
* one fracture posterior to the acetabulum
o usually through...

Vertical Shear Fracture of the Pelvis.
- frx consist of frxs of both pubic rami plus posterior frx of SI complex or sacrum:
- there is vertically oriented frx thru anterior and posterior pelvis together w/ superior displacement of lateral "acetabulum-containing" fragment of pelvis;
-...

Archive copy 2004
30-year old male, vehicular accident three (3) months prior to this consult, underwent ORIF (anterior scar), non-ambulatory ever since, radiograph was taken one month after initial surgery, no bladder or bowel problems, no neurologics, leg length discrepancy equals 4cm, presently complains of persistent pain and inability to ambulate.

Stable injuries
- few major long term problems
- Pain if present mild or mod

Unstable pelvis
- 30% pain
- 3% nonunion post complex
- 5% malunion =>2.5cm LLD
- 5% permanent nerve damage
- 3% urethral problems following urethral rupture

OWL Editor's note: This page states "The following article is provided by Body Mechanics & Gainesville PT for the sole purpose of educating and informing our current and future patients." However the discussion is quite technical and there is a description of the surgical technique of percutaneous SI fixation.

posterior column extends from obturator foramen thru posterior aspect of the wt bearing dome of acetabulum & then obliquely thru greater sciatic notch;
- frx of posterior rim & posterior column arise from MVA, most likely as result...

indicated for SI joint disruptions and for some sacral fractures
Operative Technique:
- radiographs:
- surgical strategy:
Fluorscopic Imaging:
reduction methods:
Structures at Risk:
Complications

In those cases we proceeded to a partial reduction in a traction table and a final acute or continuously "fine tuning" with a Ilizarov frame constructed with two half arches connected by two squaring devices which permit to mobilize the hemi pelvis in all directions, controlling both the pubic...

The trochanter flip (digastric trochanteric osteotomy) can be used to extend the exposure of the Kocher-Langenbeck approach superiorly and anteriorly. When full exposure of the inferior portion of the posterior column is not required, this trochanteric flip osteotomy can be utilized as well with the Gibson approach. This exposure can be combined...