Technical Note on Placement of Low Profile Triangular Osteosynthesis for Unstable Posterior Pelvic Ring Injuries

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kevin Steelman ◽  
Ryan Bray ◽  
Rahul Vaidya
Keyword(s):  
Pelvic Ring ◽  
Technical Note ◽  
Posterior Pelvic Ring ◽  
Pelvic Ring Injuries ◽  
Triangular Osteosynthesis ◽  
Low Profile

scholarly journals Use of the Pelvic C-Clamp to Mitigate Acute Respiratory Distress Syndrome in a Patient with an Unstable Sacral Fracture

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Michael J. DeRogatis ◽  
Paul S. Issack
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Pelvic Ring ◽  
Sacral Fracture ◽  
Posterior Pelvic Ring ◽  
Pelvic Ring Injuries ◽  
Definitive Surgery ◽  
Pelvic Instability

Case. We present the case of a 21-year-old man who fell from a roof, sustaining a displaced sacral fracture with pelvic instability. He developed acute respiratory distress syndrome (ARDS) within 24 hours of injury. Placement of the pelvic C-clamp resulted in rapid resolution of pulmonary dysfunction, allowing for definitive internal fixation. Conclusion. The C-clamp is most commonly used to control hemorrhage in unstable posterior pelvic ring injuries. Our case demonstrates a rare use of the C-clamp to stabilize the posterior pelvis in a patient with an unstable sacral fracture and ARDS, to rapidly improve pulmonary function prior to definitive surgery.

scholarly journals Complications associated with the use of ilio-sacral screw fixation in posterior pelvic ring injuries

Injury Extra ◽  
2010 ◽  
Vol 41 (12) ◽  
pp. 151
Author(s):  
A.J.B. Tasker ◽  
A. Odutola ◽  
R. Fox ◽  
C. Morrey ◽  
A.J. Ward ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Pelvic Ring ◽  
Posterior Pelvic Ring ◽  
Pelvic Ring Injuries

scholarly journals Comparison of Lumbopelvic Fixation and Iliosacral Screw Fixation for the Treatment of Bilateral Sacral Fractures

2021 ◽  
Author(s):  
Katharina E. Wenning ◽  
Emre Yilmaz ◽  
Thomas A. Schildhauer ◽  
Martin F. Hoffmann
Keyword(s):  
Operative Time ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Weight Bearing ◽  
Iliosacral Screw ◽  
Posterior Pelvic Ring ◽  
Sacral Fractures ◽  
Lumbopelvic Fixation ◽  
Pelvic Ring Injuries ◽  
Iliosacral Screw Fixation

Abstract Background: Bilateral sacral fractures result in traumatic disruption of the posterior pelvic ring. Treatment for unstable posterior pelvic ring fractures should aim for fracture reduction and rigid fixation to facilitate early mobilization. Iliosacral screw fixation (ISF) and lumbopelvic fixation (LPF) were recommended for the treatment of these injuries. No algorithm or gold standard exists for surgery of these fractures. Purpose: The purpose of this study was to evaluate the differences between ISF and LPF in bilateral sacral fractures regarding intraoperative procedures, complications, and postoperative mobilization. The secondary aim was to determine if demographics influence surgical treatment.Methods: Over a 4-year period (2016-2019) 188 consecutive patients with pelvic ring injuries were treated at one academic level-1 trauma center and retrospectively identified. Fractures were classified according to the AO/OTA classification system. 77 patients were treated with LPF or ISF in combination with internal fixation of pubic rami fractures and could be included in this study. Comparisons were made between demographic and perioperative data. Infection, hematoma, and hardware malpositioning were used as complication variables. Mobilization with unrestricted weight-bearing was used as outcome variable. Follow-up was at least 6 months postoperatively.Results: Operative stabilization of bilateral posterior pelvic ring injuries was performed in 77 patients. Thereof, 29 patients (females 59%) underwent LPF whereas 48 patients (females 83%) had bilateral ISF. The ISF group was older (76 yrs.) compared to the LPF group (62 yrs.) (p=0.001), but no differences regarding BMI or comorbidities were detected. Time for surgery was reduced for patients who were treated with ISF compared to lumbopelvic fixation (165 min vs. 73 min; respectively, p<0.001). But this did not result in reduced fluoroscopic time or radiation exposure. Overall complication rate was not different between the groups. Patients with LPF had a greater length of stay (p=0.008) but were all weight-bearing as tolerated when discharged (p<0.001). Conclusion: Bilateral posterior pelvic ring injuries of the sacrum can be sufficiently treated by LPF or ISF. LPF allows immediate weight-bearing which may benefit younger patients and patients with an elevated risk for pneumonia or other pulmonary complications. Treatment with ISF reduces operative time, length of stay and postoperative wound infection. Elderly patients may be better suited for treatment with ISF if there is concern that the patient may not tolerate the increased operative time.

Open versus percutaneous fixation of unstable posterior pelvic ring injuries

2019 ◽  
Vol 32 (2) ◽  
pp. 640
Author(s):  
EmadE El Agroudy ◽  
El-SayedM Zaki ◽  
MahmoudM Hadhood ◽  
MostafaA Ayoub ◽  
MohamedA El Sawy
Keyword(s):  
Pelvic Ring ◽  
Percutaneous Fixation ◽  
Posterior Pelvic Ring ◽  
Pelvic Ring Injuries ◽  
Open Versus

scholarly journals Comparison of lumbopelvic fixation and iliosacral screw fixation for the treatment of bilateral sacral fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Katharina E. Wenning ◽  
Emre Yilmaz ◽  
Thomas A. Schildhauer ◽  
Martin F. Hoffmann
Keyword(s):  
Operative Time ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Weight Bearing ◽  
Iliosacral Screw ◽  
Posterior Pelvic Ring ◽  
Sacral Fractures ◽  
Lumbopelvic Fixation ◽  
Pelvic Ring Injuries ◽  
Iliosacral Screw Fixation

Abstract Background Bilateral sacral fractures result in traumatic disruption of the posterior pelvic ring. Treatment for unstable posterior pelvic ring fractures should aim for fracture reduction and rigid fixation to facilitate early mobilization. Iliosacral screw fixation (ISF) and lumbopelvic fixation (LPF) were recommended for the treatment of these injuries. No algorithm or gold standard exists for surgery of these fractures. Purpose The purpose of this study was to evaluate the differences between ISF and LPF in bilateral sacral fractures regarding intraoperative procedures, complications and postoperative mobilization. The secondary aim was to determine whether demographics influence surgical treatment. Methods Over a 4-year period (2016–2019), 188 consecutive patients with pelvic ring injuries were treated at one academic level 1 trauma center and retrospectively identified. Fractures were classified according to the AO/OTA classification system. Seventy-seven patients were treated with LPF or ISF in combination with internal fixation of pubic rami fractures and could be included in this study. Comparisons were made between demographic and perioperative data. Infection, hematoma and hardware malpositioning were used as complication variables. Mobilization with unrestricted weight bearing was used as outcome variable. Follow-up was at least 6 months postoperatively. Results Operative stabilization of bilateral posterior pelvic ring injuries was performed in 77 patients. Therefore, 29 patients (females 59%) underwent LPF whereas 48 patients (females 83%) had bilateral ISF. The ISF group was older (76 yrs.) compared to the LPF group (62 yrs.) (p = 0.001), but no differences regarding BMI or comorbidities were detected. Time for surgery was reduced for patients who were treated with ISF compared to lumbopelvic fixation (73 min vs. 165 min; respectively, p < 0.001). But this did not result in reduced fluoroscopic time or radiation exposure. Overall complication rate was not different between the groups. Patients with LPF had a greater length of stay (p = 0.008) but were all weight bearing as tolerated when discharged (p < 0.001). Conclusion Bilateral posterior pelvic ring injuries of the sacrum can be sufficiently treated by LPF or ISF. LPF allows immediate weight bearing which may benefit younger patients and patients with an elevated risk for pneumonia or other pulmonary complications. Treatment with ISF reduces operative time, length of stay and postoperative wound infection. Elderly patients may be better suited for treatment with ISF if there is concern that the patient may not tolerate the increased operative time.

scholarly journals Surgical treatment of the unstable type C pelvic injury

2013 ◽  
Vol 60 (2) ◽  
pp. 53-58 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Jordan Saveski ◽  
Ivan Micic ◽  
Milan Mitkovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Open Reduction ◽  
Pelvic Ring ◽  
Posterior Pelvic Ring ◽  
Pelvic Ring Injuries ◽  
Pelvic Injuries ◽  
Ring Complex ◽  
Type C ◽  
Stable Internal Fixation

Rotationally and vertically unstable injuries to the pelvic ring (Type C) require stabilisation of the anterior and posterior pelvic ring complex. Inadequate treatment of these injuries leads to chronic instability of the pelvic ring, which can finally cause permanent disability. Open reduction and stable internal fixation of the anterior and posterior complex of unstable pelvic ring injuries are standard procedures in the treatment of hemodynamically stable patients with (Type C) pelvic injuries. Our aim is to show that this type of treatment achieves excellent and good results. All patients were operated on using the method of open reduction and anterior plate fixation of sacroiliac complex as well as fixation of the pubic symphisis. We present a retrospective study of the results concerning the treatment of 19 patients with (Type C ) unstable pelvic injuries. The average age of the patients was 43,21 years old. The final functional results, 2 years post-surgery according to the Majeed scoring system and the results were excellent in 11 (57.89%) and good in 8 (42.1%) patients. There were no bad results to report. Type C pelvic ring injuries are unstable and unless they are adequately treated, they can lead to permanent consequences. Surgical treatment that includes open reduction and stable internal fixation of the anterior and posterior pelvic ring complex leads to excellent and good results. The patients that were treated surgically by fixation of the anterior and posterior pelvic ring complex return to their everyday lives and work activities.

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