Pelvic
Salter Osteotomy
– Discussion: – type of open wedge innominate osteotomy which extends and retroverts acetabulum around fixed axis; – osteotomy redirects entire acetabulum so that its roof covers femoral head both anteriorly and superiorly; – extends and retroverts acetabulum around fixed axis; – in … Read more
Sacroiliac Fracture – Dislocations
– See: – Posterior Pelvic Injuries – Sacral Fractures – cresent fracture: (iliac fracture) – Fixation Techniques: – SI joint dislocation: posterior screw fixation: – Kellum et al 1987, unstable SI joint dislocations can produce long term pain in 60% that are treated non operatively … Read more
Sacrum and Sacral Fractures
– See: – Posterior Pelvic Injury: – Sacroiliac Fracture Dislocations: – Sacral Stress Fractures: – Anatomy of Sacrum: – Classification: – zone I: – frx across sacral ala can cause L5 nerve root impingement; – about 6% … Read more
Rx of CDH: Ages 3 years to 8 years
– See: Chiari osteotomy – Discussion: – most of these pts will require open reduction; – usually involves open reduction combined with femoral shortening; – femoral shortening: – aids in reduction; – decreases potential complications; … Read more
Sacral Stress Fractures
– Discussion: – insufficiency frxs of sacrum and pelvis may be confused w/ metastatic lesions, especially if bony resorption occurs at frx ends; – these injuries may also occur in patients with known malignant disease who have a sudden onset of pain in the lower back, hip, or groin; … Read more
Roof Arc Measurements for Acetabular Frx
– Discussion – roof arc concept (Matta, et al (1986)), and was based on analysis of 204 acetabular fractures with avg 3.7 year follow up; – helps determine the amount of intact acetabular dome; – is a useful method for determining need for surgery, however, it is less … Read more
Retrograde Medullary Superior Ramus Screw
– Discussion: – indicated for disruption of anterior pelvic ring frx: (APC II)when conditions for open forms of fixation are not optimal; – serve as an alternative to standard plating techniques for pubic ramus fixation; – in the case of pubic ramus frx in addition to symphysis dislocation, the retrograde screw is … Read more
Renal Trauma / Urogenital Trauma
– See: – Bleeding from Pelvic Frx – Urogenital Trauma from Pelvic Frx – Diff Dx of Hematuria – Discussion: – pts w/ high probability for genito-urinary trauma include those w/ gross hematuria (or microscopic) associated w/ shock; – most severe injuries tend to occur w/ … Read more
Renal Osteodystrophy
– See: – Calcitriol – Hyperparathyroidism – Renal Failure: (Orders for the CRF Patient) – Renal Spondyloarthropathy – Vit D – Effects on Adult Bone: – abnormalities of renal function can produce profound bone disease; … Read more