[ORT-L] Transverse Acetab Fx/APC Ring Followup


	MAIN INDEX	SEARCH POSTS	WHO'S ONLINE	LOG IN

Forum: OWL Lists: OTA:
[ORT-L] Transverse Acetab Fx/APC Ring Followup

jjbrooksmd at gmail
New User

Jan 14, 2009, 6:17 AM

Post #1 of 1 (7385 views)
Shortcut

[ORT-L] Transverse Acetab Fx/APC Ring Followup	Can't Post

>
>
>
> I think we need a competing thread for the excellent ongoing lower
> extremity discussions going on, so:
> -------------------------------------------------------------------------------------------------
> Looking for feedback on this case. Postop films in attached .ppt
>
> Patient brought to OR PID6 for R SI fixation and anterior frame.
>
> Looks like he will be unable to tolerate anything but a minimal
> access/percutaneous procedure for quite a while as renal function
> still worsening.
> considering return for percutaneous reduction of the symphysis/tab
> thru anterior stab incision, hammering/manipulating
> the symphysis back into place with a ball tipped pusher to improve
> symphysis and acetabulum (hopefully can make it better than the
> current position - attached fluoros/CT), and perc column fixation.
> of course, if renal function improves within next week will open and
> go ilioinguinal, clean, reduce, plate symphysis and ant col with
> post col lag screw from pelvic brim --> ischium, but I doubt that
> will be possible.
>
> QUESTIONS:
> 1) Is the symphysis/ant column reducible after more than a week thru
> small anterior stab incision using ball-tipped pusher on pubic
> tubercle without an open exposure of symphysis and pelvic brim/ant
> column?
>
> 2) If so, is percutaneous column fixation alone enough if symphysis
> is protected with anterior fixator?
>
> 3) And, on prevention, immediate filter would have prevented this
> guy’s PE so would have prevented need for embolectomy and therefore
> renal function would be ok and open surgery would be possible:
> Do you have a protocol or guidelines for IVC filter implantation in
> your institution for patients with unstable pelves??
>
> 4) Other thoughts/pearls?
>
> Thanks very much,
>
> Jeff Brooks
> Stamford, CT
>

Attachments:

TSVS tab APC ring followup.ppt (1.32 MB)

Search for (options)