Supra-Acetabular & Iliac Crest Pelvic Ex Fix Objectives –To define & describe the principles of pelvic ring stability obtained with external fixation. –To apply a supra-acetabular pelvic external fixator construct. –To apply an iliac crest pelvic external fixator construct. –To differentiate the advantages & disadvantages of a supra-acetabular frame compared to an iliac crest frame.

Principles Of Pelvic Ring Stability Obtained With External Fixation Pelvic ex fix may serve as an adjunct to resuscitation Complete (or partial) immediate pelvic ring mechanical stability Some pelvic ring deformities will not be rendered “stable” with pelvic ex fix alone Application can aide reduction in some ring injuries Pelvic ex fix can be definitive treatment in some pelvic ring injuries

Supra-Acetabular Ex Fix Ex fix pin placed at AIIS in the bone corridor from the anterior column toward the posterior column Pin runs in a “supra-acetabular” direction 5 or 6 mm pin ~200 – 350mm in length 1 or 2 pins on each side Single bar is acceptable, provided abdominal clearance

Supra-Acetabular Ex Fix

Outlet Obturator Oblique

Iliac Oblique

Inlet Obturator Oblique

Iliac Crest Ex Fix Ex fix pin placed at gluteal tubercle in the bone corridor from iliac crest toward the acetabulum Pin runs parallel to the tables of the ilium 5 or 6 mm pin ~200 – 350mm in length 1-3 pins on each side Usually 2-3 bars, must provide abdominal clearance

Iliac Crest Ex Fix

Lab Equipment Sawbone Model – –Diastasis & SI Disruption # Reduction Clamps –Weber – Pointed Reduction –Jungbluth – Screw Reduction Clamp Implants –Small Frag Set w/ Long Screws (at least mm) –4 – 6 hole pubic plate or recon plate Equipment –Drill / Driver –Recon Bending Pliers