Pelvic Fractures (Subscribe)  

Conclusion 2D-fluoroscopic navigation is a safe tool providing high accuracy of percutaneous screw placement for pelvic ring fractures, but in cases of a bilateral iliosacral screw fixation an increased risk for screw misplacement was observed. If additional ramus pubic screw fixations are performed, the retrograde inserted screws have to pass the...

Report on article in AJR (Am J Roentgenol. 2010;94:1054-1060.)
The results showed that X-ray missed a number of fractures and that MRI revealed many fractures undetected by X-ray. Among other findings:
* 13 patients (14%) had 23 fractures (6 hip, 17 pelvic) undetected by X-ray but confirmed by MRI
* 11 patients (12%)...

Percutaneous sacro-iliac (SI) screw fixation represents a widely used technique in the management of unstable posterior pelvic ring injuries and sacral fractures. The misplacement of SI-screws under fluoroscopic guidance represents a critical complication for these patients. This study was designed to determine the prevalence of sacral dysmorphia and the radiographic...

A 55 year-old male presented to the emergency room complaining of pelvic and abdominal pain following a crush injury between a bulldozer and another vehicle.

classification: includes ten fracture types subdivided by 5 simple fractures and 5 combined fracture patterns;

This module shows step-by-step descriptions of

• Diagnosis
• Patient preparation
• Approaches
• Reduction & fixation
• Aftercare

 
for all acetabular fractures of the Letournel classification system.
In addition, there are videos, animations, journal articles and book chapters from AO publications
 
Authored by Keith Mayo, Pol Rommens, Carlos Sancineto, Michel Oransky, Executive editor: Peter Trafton

anterior column extends from symphysis pubis & obturator foramen thru acetabulum to ASIS and up through iliac crest;
- anterior column is less frequently fractured than posterior column due to frequency of posteriorly directed forces;

Open Surgical Approach
Indications:
- open book pelvis injury w/ greater than a 2.5 cm pubic diastasis;
- note that fixation of pubic rami fractures can be much more complex than the fixation of a simple diastasis;
  - controversies:
    - management of anterior symphyseal injuries w/ concomitant urethra injury:
    - consider...

The extended iliofemoral approach exposes the entire lateral innominate bone, by posterior reflection of the abductors, and reflection of short external rotators. It can be extended anteriorly into the first iliac window of the ilioinguinal incision. The extended iliofemoral approach involves significant stripping of the bone, is associated with heterotopic bone...

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...