Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Disruptions of the Pelvic Ring: An Update 16 articles

Articles

What Is the Infection Rate of the Posterior Approach to Type C Pelvic Injuries?

Michael D. Stover MD, Stephen Sims MD, Joel Matta MD

Pelvic ring injuries with complete disruption of the posterior pelvis (AO/OTA Type C) benefit from reduction and stabilization. Open reduction in early reports had high infectious complications and many surgeons began using closed reduction and percutaneous fixation. Multiple smaller studies have reported low infection rates after a posterior approach, but these rates are not confirmed in larger series of diverse fractures.

Is Fixation Failure After Plate Fixation of the Symphysis Pubis Clinically Important?

Stephen A. C. Morris FRCS, Jeremy Loveridge FRCS, David K. A. Smart FRCS, Anthony J. Ward FRCS, Tim J. S. Chesser FRCS (Orth)

Plate fixation is a recognized treatment for pelvic ring injuries involving disruption of the pubic symphysis. Although fixation failure is well known, it is unclear whether early or late fixation failure is clinically important.

What Are the Patterns of Injury and Displacement Seen in Lateral Compression Pelvic Fractures?

Michael J. Weaver MD, Wendy Bruinsma MD, Eugene Toney MD, Erica Dafford MD, Mark S. Vrahas MD

Lateral compression (LC)-type pelvic fractures encompass a wide spectrum of injuries. Current classification systems are poorly suited to help guide treatment and do not adequately describe the wide range of injuries seen in clinical practice.

Surgical Technique: A Percutaneous Method of Subcutaneous Fixation for the Anterior Pelvic Ring: The Pelvic Bridge

Timothy G. Hiesterman DO, Brian W. Hill MD, Peter A. Cole MD

Management of pelvic ring injuries using minimally invasive techniques may be desirable if reduction and stability can be achieved. We present a new technique, the anterior pelvic bridge, which is a percutaneous method of fixing the anterior pelvis through limited incisions over the iliac crest(s) and pubic symphysis.

Radiographic Changes of Implant Failure After Plating for Pubic Symphysis Diastasis: An Underappreciated Reality?

Cory Collinge MD, Michael T. Archdeacon MD, Elizabeth Dulaney-Cripe MD, Berton R. Moed MD

Implant failure after symphyseal disruption and plating reportedly occurs in 0% to 21% of patients but the actual occurrence may be much more frequent and the characteristics of this failure have not been well described.

Is Application of an Internal Anterior Pelvic Fixator Anatomically Feasible?

David J. Merriman MD, William M. Ricci MD, Christopher M. McAndrew MD, Michael J. Gardner MD

Spinal hardware has been adapted for fixation in the setting of anterior pelvic injury. This anterior subcutaneous pelvic fixator consists of pedicle screws placed in the supraacetabular region connected by a contoured connecting rod placed subcutaneously and above the abdominal muscle fascia.

What are Predictors of Mortality in Patients with Pelvic Fractures?

Joerg H. Holstein MD, Ulf Culemann MD, Tim Pohlemann MD

Our knowledge of factors influencing mortality of patients with pelvic ring injuries and the impact of associated injuries is currently based on limited information.

Can Lumbopelvic Fixation Salvage Unstable Complex Sacral Fractures?

Clifford B. Jones MD, Debra L. Sietsema RN, PhD, Martin F. Hoffmann MD

Traditional screw or plate fixation options can be used to fix the majority of sacral fractures. However, these techniques are unreliable with dysmorphic upper sacral segments, U-fractures, osseous compression of neural elements, and previously failed fixation. Lumbopelvic fixation can potentially address these injuries but is a technically demanding procedure requiring spinal and pelvic fixation and it is unclear whether it reliably corrects the deformity and restores function.

Initial Experience Using a Pelvic Emergency Simulator to Train Reduction in Blood Loss

Tim Pohlemann MD, Ulf Culemann MD, Joerg H. Holstein MD

Because the average exposure of surgeons to pelvic injuries with life-threatening hemorrhage is decreasing, training opportunities are necessary to prepare surgeons for the rare but highly demanding emergency situations. We have developed a novel pelvic emergency simulator to train surgeons in controlling blood loss.

Persistent Impairment After Surgically Treated Lateral Compression Pelvic Injury

Martin F. Hoffmann MD, Clifford B. Jones MD, Debra L. Sietsema RN, PhD

Recently, fixation of lateral compression (LC) pelvic fractures has been advocated to improve patient comfort and to allow earlier mobilization without loss of reduction, thus minimizing adverse systemic effects. However, the degree of acceptable deformity and persistence of disability are unclear.

Complications of Anterior Subcutaneous Internal Fixation for Unstable Pelvis Fractures: A Multicenter Study

Rahul Vaidya MD, Erik N. Kubiak MD, Patrick F. Bergin MD, Derek G. Dombroski MD, Ren J. Critchlow MD, Anil Sethi MD, Adam J. Starr MD

Stabilization after a pelvic fracture can be accomplished with an anterior external fixator. These devices are uncomfortable for patients and are at risk for infection and loosening, especially in obese patients. As an alternative, we recently developed an anterior subcutaneous pelvic internal fixation technique (ASPIF).