Journal of orthopaedic trauma
-
To determine what anatomic structures are at risk after the application of a subcutaneous anterior pelvic internal fixator (APIF), from an incision over the anterior iliac crest to an incision centered over the pubic symphysis (Pfannenstiel). ⋯ The anatomic structures hypothesized to be potentially endangered because of the lack of direct visualization during APIF placement, include the LFCN, IIN, IHN, femoral nerve, femoral artery, and femoral vein. Based upon our anatomic study, APIF, which may be used for treatment augmentation of anterior pelvic ring disruptions, does not place these structures at significant risk. In addition, the reproductive structures (round ligament and spermatic cord) are in direct visualization and can easily be avoided during implant placement.
-
Acute traumatic pelvic instability mandates reduction and mechanical stabilization to maximize the chance of a good functional outcome. Posterior pelvic fixation is frequently inadequate to stabilize the pelvic ring in isolation. ⋯ However, many drawbacks exist with this treatment, most notably the high infection rates of the transcutaneous pins, impaired patient mobilization, and suboptimal mechanical properties. We present a technique of a subcutaneous anterior pelvic fixator as an alternative method of anterior pelvic ring reduction and stabilization that avoids many of the drawbacks of traditional anterior pelvic external fixation.
-
Residual dysfunction after pelvic trauma has been previously described, but limited functional outcome data are available in the female population after high-energy pelvic ring injury. The purposes of this study were to determine functional outcomes and to characterize factors predictive of outcome. ⋯ Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
-
Previous studies have reported a negative effect of pelvic trauma on genitourinary and reproductive function of women. However, fracture pattern, injury severity, and final fracture alignment have not been well studied. The purpose of this project was to describe sexual function in women after pelvic ring injury. ⋯ Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
-
Periprosthetic fractures of the acetabulum are largely underreported in the literature, none of which describes the management of such injuries associated with a pelvic ring injury. Our case report discusses our approach to managing a periprosthetic both-column acetabulum fracture associated with an open-book pelvic ring injury. Instead of a revision total hip arthroplasty, we chose to perform an open reduction internal fixation to maintain sufficient bone stock for future revision, if necessary. At 18 months postoperative follow-up, the patient was ambulating independently and had sufficient range of motion that was comparable to the contralateral hip.