Case Index Number: 003 Posted by: Injury Fixation Adam Starr, M.D.

Slides:

Advertisements

Similar presentations

Bilateral Traumatic Hip Dislocation March,2005 Dr Abdollah Mousavi Orthopeadic Surgeon Asia Hospital Tehran/Iran.

Advertisements

Pelvis Lab. Case 1 36 year old woman with pelvic pain.

Mike Gibson Glasgow Post Orthopaedic Training Program February 2011 Thoraco-Lumbar Fractures.

Ankle problems/procedures and techniques

The Acute Management of Pelvic Ring Injuries

Pelvic Ring Fractures Christy Johnson.

Acetabular Fractures Joshua Landau, MD David Seidman, MD 11/23/04.

X-Ray Rounds Cass Djurfors Feb 20, y.o. boy with leg pain Obese 10-year old male presents with a two week history of right thigh and knee pain.

 The animal will not be able to use the leg at all and if able will hold the leg up. Sometimes the foot will be rested on the ground when the animal.

PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

E. Pelvic Girdle 1. Consists of only two coxal bones a. Provide strong, stable support for the weight of the body 2. These two bones are united anteriorly.

Yoyos Dias Ismiarto, dr., SpOT(K), M.Kes, FICS., CCD.

Paper Reading Int. 林泰祺.

PELVIC INJURIES High energy trauma. May be life threatening. Road traffic accidents. Fall from height. Crush injuries.

Classification of Pelvic Fractures: A Mechanistic Approach

Fractures of the Acetabulum Dr Bakhtyar Baram. May be apart of alarger fracture in the pelvis or other regions like in the multitrauma pt.s. About 3/100.

Pelvic Ring Injuries: Definitive Management

ESTABILISHED STANDARD PREHOSPITAL TRANSPORT PROTOCOL AND EMERGENCY DEPARTMENT MANAGEMENT ALGORITHMS 11% PREALGORITHM 7% POST ALGORITHM.

Common adult fractures Axial skeleton (Pelvis) Waleed M. Awwad, MD. FRCSC Assistant professor and Consultant Orthopedic Surgery department.

OSCE EXAM SIMULATION WITH THE IDEAL ANSWER second part

Fractures general management. A high velocity injury should always be treated according to the Advanced Trauma Life Support (ATLS) guidelines with attention.

Chapter 7 Hip and Pelvis. Pelvis Connects lower extremities to the axial skeleton Consists of –____________ –1 sacrum –____________ _____________ – 2.

Intraoperative Monitoring with Stimulus-Evoked Electromyography during Placement of Iliosacral Screws. An Initial Clinical Study* by BERTON R. MOED, B.

Iliosacral Screw “Safe Zone”

BY BLUE TEAM. By Dr Kabiru Salisu NOHD  INTRODUCTION  HISTORY  EPIDEMIIOLOGY  AETIOLOGY  PATHOPHYSIOLOGY  SURGICAL ANATOMY  CLASSIFICATION.

Pelvic Ring Injuries Classification of Pelvic Ring Injuries

Fractures By Amal.

Orthopedic Problems In Multiple Trauma Patients. Miss Injury Incidence 12 % Incidence 12 % Esp. in associate with Head Injury Esp. in associate with Head.

Supra-Acetabular & Iliac Crest Pelvic Ex Fix Objectives –To define & describe the principles of pelvic ring stability obtained with external fixation.

Anatomy of the Pelvis in Computed Tomography

Male with displaced fracture of the left clavicle, treated with clavicle pin Pre-Op Post-Op Fracture healed.

Musculoskeletal Trauma

John Au Liz Abbott Dr Diana Perriman Prof. Paul Smith

Pelvis Lab Lab notes by Andrew Haims, MD. ©2004 Yale School of Medicine.

Spinopelvic Fixation in Complex Sacral Fractures by Gregory D. Schroeder, Jason W. Savage, Alpesh A. Patel, and Michael D. Stover JBJS Reviews Volume 3(3):e4.

INTERNAL MEDICINE SERIES

 Splints/Immobilizers  Casts  Traction  External Fixation  Internal Fixation  Why? SplintsSplints, casts, and braces support and protect broken.

Predicting major hemorrhage in patient with pelvic fracture J Trauma. 2006;61:346~352 Int. 林鼎博.

The Acute Management of Pelvic Ring Injuries Sean E. Nork, MD Harborview Medical Center, Seattle, Washington Original Author: Kyle F. Dickson, MD; Created.

Fracture of tibia ..

Traction By: Sarah Gobbell.

Types of Fractures Afrid, Justin, Jonathan. A fracture is a broken bone Bones are rigid, but they do bend from an outside force The severity of a fracture.

Competence of the Deltoid Ligament in Bimalleolar Ankle Fractures After Medial Malleolar Fixation* by Paul Tornetta J Bone Joint Surg Am Volume 82(6):

Pelvic Fractures Presented By: Fadel Naim M.D. Orthopedic Surgeon

25 yo healthy male college student

TCCC Change Pelvic Binders

Cervical Spine Trauma Odontoid fractures Anatomic pathology

Pelvic injuries.

Bladder: stress cystograms for assessment of suspected bladder injury following blunt trauma to pelvis. (A) Stress cystogram in patient with gross hematuria.

Arterial injuries in the thoracic outlet syndrome

Pelvis fracture.

Case Index Number: 001 Posted by: Injury Fixation Adam Starr, M.D.

Pelvic Trauma Radiology

Pelvic Reduction Frame Case 1

Hiroki Funasaki, M. D. , Hiroteru Hayashi, M. D. , Hajime Sugiyama, M

Tomasz A. Nowacki, Jeffrey D. Jirsch

Itai Gans, B.S., Oladapo M. Babatunde, M.D., Theodore J. Ganley, M.D.

Case Index Number: 002 Posted by: Injury Fixation Adam Starr, M.D.

CORE Case 8 Workshop GI: Trauma

Arterial injuries in the thoracic outlet syndrome

Novel fixation method of a periprosthetic fracture of the acetabulum using burr holes through the retained cup for locking screw fixation James A. Browne,

Arthroscopic Reduction and Internal Fixation of a Rim Fracture

Tibial plateau fracture

James L. Frank, MD a, Barry L. Reimer, MD b, John J. Raves, MD, FAGS a

Arthroscopic Reduction and Internal Fixation of a Rim Fracture

Posterior sternoclavicular dislocation in 16-year-old man. A

Kyle F. Dickson, M.D. M.B.A. Professor Baylor College of Medicine

A CASE OF NEGLECTED PELVIS FRACTURE

Presentation transcript:

Case Index Number: 003 Posted by: Injury Fixation Adam Starr, M.D. Parkland Hospital Dallas, TX Bilateral; SI joint disruptions; Rami fractures IS screws; In-fix

Pelvic Fracture 40 year old male 6’2”, BMI approx 30 MVC SBP 80mm Hg on arrival ATLS L side chest tube placed

Pelvic Fracture Taken for pelvic angiography R sided obturator artery branch embolized Undergoes R upper quadrant exploration for diaphragm repair Post-operatively to SICU Binder maintained in place

Fracture Pattern Appears to be an LC 3 R hemipelvis appears to have rolled in. Portion of R ala is impacted Triangle of bone knocked off R ala at level of impaction Small crescent from posterior portion of R ilium left in place L SI joint appears widened anteriorly

SICU Course Patient stabilized hemodynamically Binder removed – no traction Taken to OR for pelvic fx repair 6 days after admission

Operating Room Fluoro reveals worsened displacement of both sides of posterior pelvic ring.

R SI joint is wide…and up…

…and back.

L SI joint is wide…

…and back…

…but not up.

R leg skeletal traction

Traction on R leg Improved cephalad displacement some Didn’t affect R SI gap R ilium anchored to pelvic reduction frame

L side – kugelspitz with motor attached to frame to improve L SI widening

L iliosacral screw used to compress L SI joint further

Stabilized L side now anchored to frame Stabilized L side now anchored to frame. Pins placed in R AIIS, used to pull R ilium forward

Kugelspitz used to rotate R ilium externally and close gap of R SI joint

R sided iliosacral screw placed

Anterior ring. Alignment acceptable. Markedly bruised, edematous.

Infix bar placed