Pelvic Ring Injuries Definitive Management骨盆环损伤的明确的管理.pptVIP

Acknowledgment Return to Pelvis Index E-mail OTA about Questions/Comments If you would like to volunteer as an author for the Resident Slide Project or recommend updates to any of the following slides, please send an e-mail to ota@aaos.org * Reduction and Fixation:Symphysis Reduction with clamp Jungbluth clamp with screws Matta and Tornetta, CORR 329, pp129-140, 1996 Reduction and Fixation:Symphysis Pelvic reconstruction plate Commonly 6 hole plate Variable directions of screws Reduction and Fixation:Ramus Fractures Pelvic reconstruction plate Medullary screw fixation Retrograde Antegrade Reduction and Fixation:Ramus Fractures Pelvic reconstruction plate Medullary screw fixation Retrograde Antegrade Reduction and Fixation:Ramus Fractures Pelvic reconstruction plate Medullary screw fixation Retrograde Antegrade Reduction and Fixation:Ramus Fractures Anterior External Fixation Controls rotation only Pins in gluteus medius pillar of ilium Alternative placement in Anterior Inferior Iliac Spine Reduction and Fixation:SI Joint Dislocation Anterior exposure facilitates reduction of dislocation Iliac window of ilioinguinal approach Pelvic brim SI Joint Reduction and Fixation:SI Joint Dislocation Clamp applied from lateral, posterior ilium to anterior sacral ala Reduction and Fixation:SI Joint Dislocation Plating Need more than one plate to avoid linkage displacement Can be used in tandem or with SI screw Reduction and Fixation:SI Joint Dislocation SI screw Cannulated for ease of placement Partially threaded for reduction Fully threaded for improved fixation Knowledge of anatomy and imaging is essential Be aware of sacral dysmorphism Reduction and Fixation:SI Joint Fracture/Dislocation“Crescent Fracture” SI screw If caudal segment is in the path of fixation screw Opportunity for percutaneus treatment Reduction and Fixation:SI Joint Fracture/Dislocation“Crescent Fracture” SI screw and plate Anterior ORIF if large fragment Supplement as needed with