scholarly journals A Method of Using a Pelvic C-Clamp for Intraoperative Reduction of a Zone 3 Sacral Fracture

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Daniel H. Wiznia ◽  
Nishwant Swami ◽  
Chang-Yeon Kim ◽  
Michael P. Leslie
Keyword(s):  
Closed Reduction ◽  
Pelvic Ring ◽  
Sacral Fracture ◽  
Pelvic Ring Injury ◽  
Open Book ◽  
Long Term Outcomes ◽  
Pelvic Ring Injuries ◽  
Emergency Stabilization ◽  
Reduction Methods

It is challenging to properly reduce pelvic ring injuries that involve a zone 3 sacral fracture. Several open and closed reduction methods have been described. Percutaneous reductions are challenging, and improper reductions can have poor long-term outcomes. The pelvic C-clamp is a tool designed to provide emergency stabilization to patients suffering from c-type pelvic ring injuries. We describe a case in which a patient’s open book pelvic ring injury with a zone three sacral fracture is reduced intraoperatively with the use of a pelvic C-clamp and stabilized with transsacral screws.

The Longitudinal Short-, Medium-, and Long-Term Functional Recovery After Unstable Pelvic Ring Injuries

2019 ◽  
Vol 33 (12) ◽  
pp. 608-613 ◽  
Author(s):  
Michael E. Neufeld ◽  
Henry M. Broekhuyse ◽  
Peter J. OʼBrien ◽  
Pierre Guy ◽  
Kelly A. Lefaivre
Keyword(s):  
Functional Recovery ◽  
Pelvic Ring ◽  
Pelvic Ring Injuries ◽  
Unstable Pelvic Ring Injuries

scholarly journals Pelvic ring injury in the elderly: Fragile patients with substantial mortality rates and long-term physical impairment

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0216809 ◽  
Author(s):  
Hester Banierink ◽  
Kaj ten Duis ◽  
Rob de Vries ◽  
Klaus Wendt ◽  
Erik Heineman ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
The Elderly ◽  
Mortality Rates ◽  
Physical Impairment ◽  
Pelvic Ring Injury

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 An assessment of pelvic binder placement at a UK major trauma centre

2018 ◽  
Vol 100 (2) ◽  
pp. 101-105 ◽  
Author(s):  
H Naseem ◽  
PD Nesbitt ◽  
DC Sprott ◽  
A Clayson
Keyword(s):  
Computed Tomography ◽  
Continuing Education ◽  
Retrospective Review ◽  
Major Trauma ◽  
Pelvic Ring ◽  
Trauma Centre ◽  
Pelvic Ring Injury ◽  
Pelvic Ring Injuries ◽  
Pelvic Binder ◽  
Major Trauma Centre

Introduction Pelvic binders are used to reduce the haemorrhage associated with pelvic ring injuries. Application at the level of the greater trochanters is required. We assessed the frequency of their use in patients with pelvic ring injuries and their positioning in patients presenting to a single major trauma centre. Methods A retrospective review of our trauma database was performed to randomly select 1000 patients for study from April 2012 to December 2016. Patients with a pelvic binder or a pelvic ring injury defined by the Young and Burgess classification were included. Computed tomography was used to identify and measure pelvic binder placement. Results 140 patients were identified: 110/140 had a binder placed. Of the total, 54 (49.1%) patients had satisfactory placement and 56 (50.9%) had unsatisfactory placement; 30/67 (44.8%) patients with a pelvic ring injury had no binder applied, of whom 6 (20%) had an unstable injury; 9/67 patients died. Discussion This is the first study assessing pelvic binder placement in patients at a UK major trauma centre. Unsatisfactory positioning of the pelvic binder is a common problem and it was not used in a large proportion of patients with pelvic ring injuries. This demonstrates that there is a need for continuing education for teams dealing with major trauma.

scholarly journals Infection after the use of INFIX in Pelvic Ring Injuries

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 46
Author(s):  
Rahul Vaidya ◽  
Karun Amar ◽  
Derrek Woodbury ◽  
Austen Washington
Keyword(s):  
Pelvic Ring ◽  
X Rays ◽  
Pelvic Fixation ◽  
Pelvic Ring Injuries ◽  
Small Series ◽  
Loss Of Reduction ◽  
Irrigation And Debridement ◽  
Radiographic Union

Introduction: The purpose of this study is to report on infection with anterior subcutaneous internal pelvic fixation (INFIX) for pelvic ring injuries and the outcomes of treatment. Methods: An IRB-approved retrospective study was performed using trauma databases of a level one and level two trauma center from 2012–2018. Infection after the INFIX procedure was diagnosed in 10 of 179 cases. Treatment included formal irrigation and debridement, removal of the hardware, and culture-specific antibiotics. Patients were followed for a minimum of 12 months. Recorded outcomes include X-rays, Majeed scores, and the presence of any loss of reduction using reduction parameters. Results: Time to detect the infection was 54.2 ± 24.3 days (range 24–90, median 56 days). Staphylococcus aureus was the most common bacteria isolated. The average follow-up was 830 ± 170 days (range 575–1088 days). All patients went on to the radiographic union. There were no recurrent infections or osteomyelitis at the latest follow-up. Patients maintained their reduction after INFIX removal (KI), and Majeed scores ranged from 72 to 96 (seven good, three excellent). Discussion: Infections after using the INFIX procedure were dealt with by irrigating and debriding the wounds, removing the INFIX with culture-specific antibiotics for 2–6 weeks. Implants were maintained for at least 25 days, and there was no loss of reduction. There were no long-term sequelae noted in this small series or the literature review included in this paper.

Fractures of the transverse processes of the fourth and fifth lumbar vertebrae in patients with pelvic ring injuries

2018 ◽  
Vol 100-B (9) ◽  
pp. 1214-1219 ◽  
Author(s):  
M. Winkelmann ◽  
M. Lopez Izquierdo ◽  
J-D. Clausen ◽  
E. Liodakis ◽  
P. Mommsen ◽  
...  
Keyword(s):  
Pelvic Fracture ◽  
Pelvic Ring ◽  
Lumbar Vertebrae ◽  
Transverse Process ◽  
Trauma Centre ◽  
Pelvic Injury ◽  
Matched Pair ◽  
Haemodynamic Instability ◽  
Pelvic Ring Injury ◽  
Pelvic Ring Injuries

Aims This study aimed to analyze the correlation between transverse process (TP) fractures of the fourth (L4) and fifth (L5) lumbar vertebrae and biomechanical and haemodynamic stability in patients with a pelvic ring injury, since previous data are inconsistent. Patients and Methods The study is a retrospective matched-pair analysis of patients with a pelvic fracture according to the modified Tile AO Müller and the Young and Burgess classification who presented to a level 1 trauma centre between January 2005 and December 2014. Results A total of 728 patients with pelvic ring injuries were included, of whom 183 (25.1%) had a biomechanically unstable pelvic fracture. Of these patients, 84 (45.9%) had a fracture of a TP of L4 and/or L5. A total of 73 patients (13.4%) with a stable pelvic ring injury (p < 0.001) had a fracture of a TP. Patients with a fracture of a TP of L4 and/or L5 had a 5.5-fold risk (odds ratio (OR)) of having a biomechanically unstable pelvic injury. TP fractures (OR 1.6, p = 0.2) could not be confirmed as an independent predictor of haemodynamic instability. Conclusion This is the first study that has demonstrated a positive correlation between a TP fracture of L4 and/or L5 and a biomechanically unstable pelvic ring injury. The presence of transverse process fractures of L4 and/or L5 indicates increased severity of pelvic injury and therefore can help in the planning of emergency treatment. Cite this article: Bone Joint J 2018;100-B:1214–19.

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