RE: Pelvic Ring Disruption in 16 yo (was RE: [ORT-L] 3Month old fracture neck of femur)


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RE: Pelvic Ring Disruption in 16 yo (was RE: [ORT-L] 3Month old fracture neck of femur)

fbwilson at earthlink
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Aug 1, 2006, 1:25 PM

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RE: Pelvic Ring Disruption in 16 yo (was RE: [ORT-L] 3Month old fracture neck of femur)	Can't Post

Jeff, Chip, et al,

In light of further evidence (the inlet view in Jeff's response), I still
believe that this can be treated non-operatively but may require more
restricted activity in addition to the already mentioned careful monitoring
for evidence of displacement. The CT in the Power Point sent with the
original post does show the fracture but it appears to be minimally
displaced. However, with both sides of the sacrum involved, I might be more
inclined to place bilateral SI screws without fixing or ex-fixing the front.

Chip, would you be concerned with any effort to reduce the left side if you
were going to place screws?

I'm still interested in others' views on screw placement ( 1 vs 2, S1 &/or
S2, remove after healing or leave).

Thanks,

Fred

Frederic B. Wilson, M.D.

Assistant Professor

Traumatology & Adult Reconstruction

Department of Orthopaedic Surgery

Louisiana State University Health Sciences Center

2020 Gravier St., Room 728

New Orleans, LA, 70112

Phone: (504) 568-4680

Fax: (504) 568-4466

Cell: (504) 994-4555

fbwilson@earthlink.net

-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org] On Behalf
Of Chip Routt
Sent: Tuesday, August 01, 2006 1:11 AM
To: ORT-L@www2.aaos.org
Subject: Re: [ORT-L] 3Month old fracture neck of femur

Did you notice that her left hemipelvis is displaced cranially?

Did you compress her pelvis to assess its instability?

Is her right sacral fracture real?

Do you have a lateral sacral image or CT reformats?

Thanks-

Chip

Dear list members,

young lady, pinned under a car last Thurs, coming to me for second
opinion. My question is the role for surgery in this case. Would
anyone fix the L SI joint. Other?

Thanks in advance.

M.L. Chip Routt, Jr.,M.D.
Professor-Orthopedic Surgery
Harborview Medical Center
325 Ninth Avenue
Box 359798
Seattle, WA 98104-2499
phone 206-731-3658
FAX 206-731-3227
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