Journal of orthopaedic trauma
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To determine the optimal starting points for placement of S1 and S2 iliosacral screws as well as the pertinent anatomy surrounding the S1 and S2 vertebral bodies. ⋯ The iliosacral screw starting point at the posterior sacral body and inferior S1 foramen was the safest when considering the entire population. Careful attention to the size and orientation of the S2 vertebral body should be taken if S2 iliosacral screws are placed.
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To determine the effects of ipsilateral hip and knee position on intraneural sciatic nerve pressures. ⋯ Intraneural sciatic nerve pressures are influenced by the position of the ipsilateral hip and knee. The magnitude of the pressure elevation appears to be related to the excursion of the nerve as the linear distance between the greater sciatic notch and the distal aspect of the leg increases. Intraneural tissue fluid pressures measured within a localized section of the sciatic nerve appeared to exceed published critical thresholds for alterations of blood flow and neural function only when the hip was flexed to 90 degrees and the knee was fully extended.
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Comminuted iliac fractures are uncommon and difficult to treat. The purpose of this study is to further delineate the fractures, to present a management protocol, and to evaluate the results of treatment. ⋯ Comminuted iliac fractures occur in two distinct patterns and are associated with numerous local injuries that complicate management. Management protocols should include early open reduction and stable internal fixation. Traumatic open wounds should not be closed primarily. Primary closure with closed suction drainage is effective in the management of associated degloving injuries. Extension of the fracture into the greater sciatic notch warrants further evaluation with pelvic angiography.