Pelvic Fractures (Subscribe)

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Acetabular Fractures popular

Acetabular Fractures: Diagnosis, Treatment, Indications, Outcome
OTA Basic Fracture Course

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1998 The Ilioinguinal Approach in the Management of Acetabular Fractures

The subject of acetabular fracture surgery has been dealt with at length in the literature. Almost forty years after the first publications by Robert Judet and Emile Letournel, much has been written on either side of the Atlantic; however, there is nothing new in the New World or the Old. Large studies have confirmed or refined the basic tenets and the detailed points established by the two pioneers of acetabular fracture surgery. This surgery is still difficult, demanding, and to be used in stringently selected cases only. The second generation of surgeons with an interest in the surgical management of acetabular fractures will find that all the groundwork has been done. However, newcomers will still need to learn the techniques involved. They will have to be taught, not only the necessary and, indeed, indispensable theory, but the practical, day-to-day aspects of this surgery. Through practical experience, they will need to familiarize themselves with the pitfalls as well as with the tips and tricks that can help them in their craft. The knowledge of the past may be transmitted through hands-on training and through the written medium. This article is intended as a source of information, to give food for thought and practical guidance to those among our colleagues who are interested in acetabular fracture surgery.
Maîtrise Orthopédique n° 74 - May 1998

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2001 Technique of percutaneous transsacral screw stabilization for sacroiliac joint injury and sacral fractures

The low rate of postoperative complications, the good functional results aside from a few understandable failures, justify continued use of this method. Percutaneous screw fixation is not a goal in itself. It is, in our opinion, more important to stress the quality of the reduction obtained, the percutaneous screw fixation only being useful to maintain this reduction. If the reduction is not achieved by closed procedures, one should opt for another reduction technique.
Technique of percutaneous transsacral screw stabilization for sacroiliac joint injury and sacral fractures Results of a series of 20 cases F. LAUDE, Ph. PAILLARD Maîtrise Orthopédique n°108 - 2001, November

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2005 Ilioinguinal approach - modified

Indication Difficult acetabular fractures with anterior displacement in which access to the entire anterior column is required. This approach allows access to the anterior column as far as the symphysis and includes the quadrilateral plate. Most both-column fractures can also be managed through this approach, but only if the posterior fragment is large and in one piece.

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2005 Pelvic Fractures in Emergency Medicine eMedicine Emergency

Author: Charles Sheppard, MD, FACEP. 2005
Pelvic fracture is a disruption of the bony structure of the pelvis. In elderly persons, the most common cause is a fall from a standing position. However, the most significant fractures involve significant forces such as a motor vehicle crash or fall from a significant height.
Synonyms and related keywords: pelvic fracture, fracture of the pelvis, acetabular fractures, lateral compression fractures, transverse fractures of the pubic rami, avulsion fracture, Young classification system, anterior-posterior compression fractures

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2006 Pelvic Fractures eMedicine Orthopedics

Russell & Jarrett 2006 Updated 2009
Operative management of unstable pelvic injuries increased especially recently due to several factors. Improved and coordinated treatment of polytraumatized patients, improved anesthetic techniques including blood salvage systems, advances in intraoperative fluoroscopic imaging techniques, standardized pelvic implant system, and better understanding of injury and deformity patterns have allowed for successful operative treatment of patients with pelvic ring injuries. Operative management of unstable pelvic ring injuries allows for earlier patient mobilization, thereby decreasing complications associated with recumbency. Operative management also allows for correction and prevention of significant pelvic deformities, improving clinical outcomes.
Synonyms and related keywords: pelvic ring injuries, broken pelvis, cracked pelvis, shattered pelvis, fractured hip, broken hip

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2007 Pelvic Ring Fractures eMedicine Radiology

Author: D Dean Thornton, MD 2007
Pelvic ring fractures occur as the result of high-energy blunt trauma, as in motor vehicle collisions and falls. These injuries are associated with significant morbidity and mortality, both from the complications of pelvic ring fractures and from commonly associated injuries. Recognition of the pattern of injury to the bony pelvis directs the search for associated soft-tissue injuries and allows implementation of the appropriate therapy.
Synonyms and related keywords: pelvic fractures, pelvis fractures, blunt trauma, bladder rupture, vertical shear injury, anteroposterior compression injury, AP compression injury, lateral compression injury, pelvic hemorrhage, osseous pelvis, Young-Burgess classification, Tile classification, pubic diastasis, sacral buckle fracture, pubic rami fracture, iliac wing fracture

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2008 Acetabulum Fractures eMedicine Orthopedics

Thacker, Tejwani & Thakkar 2008 Updated 2009
Fractures of the acetabulum occur primarily in young adults as a result of high-velocity trauma. These fractures are often associated with other life-threatening injuries. Displacement of the fracture fragments leads to articular incongruity of the hip joint that results in abnormal pressure distribution on the articular cartilage surface. This can lead to rapid breakdown of the cartilage surface, resulting in disabling arthritis of the hip joint. Anatomic reduction and stable fixation of the fracture, such that the femoral head is concentrically reduced under an adequate portion of the weight-bearing dome of the acetabulum, is the treatment goal in these difficult fractures.

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2008 Management of Exsanguinating Pelvis Injuries

An algorithm for the management of exsanguinating pelvic trauma Karim, London, UK, May 20, 2008
Introduction Trauma patients who present with unstable pelvic fractures have sustained a high energy injury that is commonly associated with disruption of arteries and veins resulting in major haemorrhage. Patients with pelvic fractures who present in shock have a mortality of 30-50%. When combined with injuries in other body regions such as the abdomen, the mortality rises even higher, approaching 100% in some series. However a systematic multidisciplinary approach to these injuries, directed initially only at haemorrhage control, can lead to significant improvements in survival.

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2008 Unstable Pelvic Fractures eMedicine Orthopedics

Graf & Karunakar 2008
This article focuses on unstable pelvic fractures, which are usually caused by high-energy injuries. The most common high-energy mechanism of injury is a motor vehicle accident. Patients who sustain these injuries not only have the osseous injury but also often have concomitant life-threatening injuries. Younger people are more likely to be involved in these accidents. Early death after these injuries is usually due to hemorrhage, multiple organ system failure, or sepsis. These unstable high-energy pelvic fractures require a multidisciplinary approach to treatment.
Synonyms and related keywords: open-book fractures, Tile type B fractures, anterior-posterior compression injury, APC injury, lateral compression injury, LC injury, vertical shear injury, VS injury, combined mechanism injury, zone I sacral injury, zone II sacral injury, zone III sacral injury, pelvic fracture, fracture of the pelvis, acetabular fractures, lateral compression fractures, transverse fractures of the pubic rami, avulsion fracture, Young classification system, anterior-posterior compression fractures, anteroposterior compression fractures, pelvic ring injuries, broken pelvis, cracked pelvis, shattered pelvis, fractured hip, broken hip

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2009 A biomechanical study of conventional acetabular internal fracture fixation versus locking plate fixation

Conclusion: The locking plate construct is as strong as the conventional plate plus interfragmentary lag screw construct for fixing transverse acetabular fractures. Lock- ing plates may improve management of acetabular fractures by eliminating the need for placement of an interfragmentary lag screw. Furthermore, they may be helpful in revision hip arthroplasty in patients with pelvic discontinuity.
R. Mehin, B. Jones, Q. Zhu, H. Broekhuyse Can J Surg, Vol. 52, No. 3, June 2009 221 (full text)

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2009 Apophyseal Avulsion Fractures of the Hip and Pelvis

As a result of reading this article, physicians should be able to: Describe the anatomy and mechanism of injury associated with apophyseal avulsion fractures of the hip and pelvis. List the different stages of nonoperative management in patients with apophyseal avulsion. Discuss the operative treatment options and surgical approaches for treatment of these injuries.
Identify the controversies and common complications in the treatment of apophyseal avulsion fractures of the hip and pelvis. This activity is approved for one year from the date of original release, January 2009 to January 2010.
CME Accreditation
Bart I. McKinney, MD; Cory Nelson, MD; Wesley Carrion, MD ORTHOPEDICS 2009; 32:42 January 2009

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2009 Good results seen with conventional fixation of geriatric acetabular fractures

Research indicates that acute open reduction and internal fixation may lead to good outcomes in carefully selected elderly patients with displaced acetabular fractures.
ORTHOPEDICS TODAY September 2009 Good results seen with conventional fixation of geriatric acetabular fractures Early research on the limited ilioinguinal approach indicates less blood loss vs. traditional approach.

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2009 Insufficiency Fractures of the Pelvis eMedicine Radiology

Insufficiency fracture is a subgroup of stress fracture. Unlike the other subtype (ie, fatigue fracture), insufficiency fracture is caused by normal or physiologic stress upon weakened bone. Loss of bone trabeculae decreases the bone's elastic resistance.
Awareness is increasing concerning the occurrence of these fractures among older persons. Sites frequently affected by insufficiency fractures are the thoracic vertebra, the tibia, the fibula, and the calcaneus.
Wilfred CG Peh 2009

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2009 Isolated quadrilateral plate fracture

The most widely used classification of acetabular fractures is that of Letournel and colleagues. This anatomic classification divides all acetabular fractures into elementary and associated types based on the anterior and posterior columns and walls. We report the case of a patient with an isolated quadrilateral plate fracture of the pelvis associated with a supero - lateral quadrant femoral head impaction. To our knowledge, this type of acetabular fracture cannot be classified according to Letournel’s classification and has never been reported in the English literature.
Isolated quadrilateral plate fracture: an unusual acetabular fracture G.Y. Laflamme, J. Delisle, S. Leduc, P.-A. Uzel Can J Surg, Vol. 52, No. 5, October 2009

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