Ortopedia Pediátrica. Traumatología y Reemplazos articulares: Discusión entre pares / 35yrs/male presented with complex pelvic fracture without bladder and urethral injury.

miércoles, 14 de mayo de 2014

Discusión entre pares / 35yrs/male presented with complex pelvic fracture without bladder and urethral injury.

Indian-Orthopaedic Research-Group

Rahul B Tanga

35yrs/male presented with complex pelvic fracture without bladder and urethral injury.patient was resuscitated and orif with interfrag screw + 3.5mm recon plating acetabulum thr posterior approach. orif with 3.5mm 4holed double dcp for SI joint.orif with long 3.5mm cortical screw fixation for anterior column thr ileofemoral approach with ASIS osteotomy .done in a single stage procedure.

Rahul B Tanga critical comments?

Ayer a las 11:10 · Me gusta
Gopal Goel v good fixation

Ayer a las 11:12 · Me gusta · 1
Shrikant Dalal Well done..

Ayer a las 11:40 · Me gusta · 1
Sudhir Khursade Sirji excellent work

Ayer a las 11:48 · Me gusta · 1
Sachin Kumar Mall Bravo

Ayer a las 12:40 · Me gusta · 1
Dr-hussain Palh good

Ayer a las 13:05 · Me gusta · 1
Ravi Biradar Welldone....

Ayer a las 14:11 · Me gusta
Madhu Chandra P nice dr rahul, what approach was used for fixing si joint.

Ayer a las 14:55 · Me gusta · 1
Ali Alshaby nice what approach was used for fix. sa. iliaic joint

Ayer a las 15:27 · Me gusta · 1
Jassim M Alfailakawi SIJ not reduced

Ayer a las 15:42 · Me gusta · 1
Lokesh Bhatia Reasonably Well done. Any plans to do Post op CT. If not better do it for the sake of documentation, and more better understanding of Fixation. I wish your Recon Plate could have been one more hole longer you or would have pushed it more down (distal) to fix one more screw in Ischium.

Ayer a las 16:23 · Me gusta · 1
Jassim M Alfailakawi Steps of fixation 1 - reduce SIJ by close or open method then fix it with SI screw then step 2 reduce and fix the column start from periphery the proceed toward the acetabulum you will get perfect reduction ,the most difficult thing is the reduction the easy this is putting plate

Ayer a las 16:31 · Me gusta · 1
Ashwini Sood Anybody among us will like to classify this # instead of labelling this as a " COMPLEX PELVIC # " ? ?

Ayer a las 18:38 · Me gusta · 1
Rahul B Tanga Thanks everyone.

Ayer a las 19:42 · Me gusta
Rahul B Tanga Dr madhu Chandra anterior approach was used for SI joint.

Ayer a las 19:43 · Me gusta
Rahul B Tanga Dr jassim posterior column anterior column is well reduced SI joint was quite satisfactory on table . So would like to repeat X rays after few days.

Ayer a las 19:46 · Me gusta
Rahul B Tanga Rightly said Dr ashwini sood .even I want someone to classify this fracture.

Ayer a las 19:47 · Me gusta · 2
Shivaraj Chatrashali It's type C3 fracture acc to Marvin and tile classification .. Vertically and rotationally unstable ass with acetabular fracture .. Si joint is not reduced well bcoz vertical component was not taken in to consideration .. And though ideally u reduce si joint first (judet golden rule ) but this case is exception as it is ass with transverse acetabular fracture on same side .. And u could have avoided taking two approaches .. Through posterior u could have addressed transverse fracture using 2 recon plates and 1 long percutaneous anterior column screw .. Then in supine positio u could have used modified Stoopas app and fixed contra lateral rami fracture along with pubic symphysis .. By doing so ur si joint would fall in place then fixed si joint percutaneously with 6.5screw and washer

Ayer a las 21:05 · Me gusta · 1
Kir Pat Good attempt ,I assume Pelvic brim plate would have solved your problem of reduction as it has pulled for approximation by periacetabular plate applied first and added stability

Hace 23 horas · Me gusta
Ashwini Sood In my opinion ilio-femoral is one of the extensile approaches for acetabulum & it is generally not combined with kocker- Langenbach approach.
This case could have been done very nicely by
Ilio-inguinal approach.SI joint reduced & fixed anteriorly foll...Ver más

Hace 12 horas · Me gusta · 1
Ali Öner Since both rami are fractured, I would suggest plating of opposite site for safer mobilisation of patient. Sacroiliac fixation needs better anterior ring support.

9 horas · Me gusta