jjbrooksmd at gmail
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Aug 24, 2005, 12:34 PM
Post #5 of 5
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Re: [ORT-L] pelvic # with urethral injury
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If ex-fix with good anterior ring alignment I would still strongly
consider posterior fixation on the right. At the very least 2
percutaneous screws but preferably more (i.e., plating or a bar, etc)
I am in a similar situation as an upper extremity surgeon with
additional fellowship trauma training, and interest, but I don't do
much pelvic trauma and when something like this comes along I cringe,
look in the books and in the literature, and "bite the bullet".
Maybe Dr. Routt can comment?
Great case, thank you Mr. Rajesh
Jeff Brooks, Stamford, CT
On 8/24/05, T.I. George <ti.george@gmail.com> wrote:
> Dear Rajesh
>
> At the movement that seem to be the only answer to me.
>
>
> Dr T I George
>
>
>
>
> On 8/23/05, Rajesh <rajesh84@asianetindia.com> wrote:
> >
> > Would you do anything at all to the comminuted displaced pubic rami #s or
> just reduce the pelvic displacement and put the exfix on?
> >
> > thanks
> > rajesh
> >
> >
> > Mr.K.R.Rajesh,MS,DNB,FRCS,FRCS(Orth)
> > Consultant Upper Limb Surgeon,
> > Division of Upper Limb & Joint Replacement Surgery.
> > Cosmopolitan Hospital,
> > Trivandrum,Kerala,
> > India.
> > Mobile-9847350160
> >
> >
> > -----Original Message-----
> > From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org]On
> Behalf Of T.I. George
> > Sent: 23 August 2005 22:30
> > To: ORT-L@www2.aaos.org
> > Subject: Re: [ORT-L] pelvic # with urethral injury
> >
> >
> > Rajesh,
> >
> > If it was day 1, I would have tried to force my Urology colleague to avoid
> a SPC and do a transurethral catheter and primary repair(not an easy task to
> convince an urologist to do an emergency urethral repair when they are all
> busy with elctive lists). Now with an SPC almost one week old, I think you
> are forced to probably have only an ex fix and avoid a plate anteriorly.
> >
> > Best of luck.
> >
> > Dr T I George
> >
> >
> > On 8/23/05, Rajesh <rajesh84@asianetindia.com > wrote:
> > > Hi,
> > > I would greatly appreciate some advice.
> > >
> > > 25 yr old male who fell from a height 6 days ago and was treated in a
> > > peripheral hospital initially has been transferred to our hospital
> today.he
> > > had a supra pubic catheter inserted for urethral injury on the day of
> injury
> > > but nothing else has been done so far.
> > >
> > > He is stable at present.. His main injury is the vertically unstable
> right
> > > sided injury involving superior and inferior rami and a # through the
> iliac
> > > side of the sacro-iliac joint on the same side.He also has undisplaced
> > > radial neck # on the riht side.No spine injury and no abdominal or
> thoracic
> > > injury.Long bones ok.
> > >
> > > I will arrange for some CT as soon as possible.i am sending some xrays
> .My
> > > pelvic # surgical experience is limited to plating a few pubic rami #s
> and a
> > > few simple column #s while i was working with a pelvic # surgeon (about
> 3
> > > yrs ago),so I could do with some advice as to what to do next.
> > >
> > > Thanks for your input.
> > >
> > > Mr.K.R.Rajesh,MS,DNB,FRCS,FRCS(Orth)
> > > Consultant Upper Limb Surgeon,
> > > Division of Upper Limb & Joint Replacement Surgery.
> > > Cosmopolitan Hospital,
> > > Trivandrum,Kerala,
> > > India.
> > > Mobile-9847350160
> > >
> > >
> > >
> >
> >
>
>
--
Jeffrey J. Brooks, MD
Orthopaedic Surgery & Sports Medicine Center
1290 Summer Street, #4400
Stamford, CT 06905
---
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