PURPOSE: The restoration, and fixation, of normal pelvic anatomy after a windswept type injury can be a difficult endeavor and our purpose is to describe a method to accomplish this. METHODS: A stepwise and sequential technique was utilized to effectively reduce and stabilize this injury pattern. By first closing down the open disruption posteriorly and fixing with a partially threaded SI screw, a stable platform was created upon which to work from and subsequently distract and reduce the contralateral side via an anterior internal fixator (seven), external fixator (one), or plate (one). This was followed by a fully threaded SI screw in the compression side of the sacral fracture to hold the distraction. Nine consecutive patients with LC3 (61-B3.2) were included in the study with an average FU of 15 months. RESULTS: The Keshishyan deformity index revealed an initial mean deformity of 0.0456 which was corrected to 0.0170 (postop) and 0.0181 at latest follow up. This entailed an average correction of 62 % at the latest follow up. The follow-up group was significantly different from pre-op (p = 0.0040), but not post-op (p = 0.6833). Furthermore, post-op was significantly different from pre-op (p = 0.0089). CONCLUSION: This is an effective method of correcting and maintaining reduction until healing for this relatively rare and difficult-to-treat injury pattern.
PURPOSE: The restoration, and fixation, of normal pelvic anatomy after a windswept type injury can be a difficult endeavor and our purpose is to describe a method to accomplish this. METHODS: A stepwise and sequential technique was utilized to effectively reduce and stabilize this injury pattern. By first closing down the open disruption posteriorly and fixing with a partially threaded SI screw, a stable platform was created upon which to work from and subsequently distract and reduce the contralateral side via an anterior internal fixator (seven), external fixator (one), or plate (one). This was followed by a fully threaded SI screw in the compression side of the sacral fracture to hold the distraction. Nine consecutive patients with LC3 (61-B3.2) were included in the study with an average FU of 15 months. RESULTS: The Keshishyan deformity index revealed an initial mean deformity of 0.0456 which was corrected to 0.0170 (postop) and 0.0181 at latest follow up. This entailed an average correction of 62 % at the latest follow up. The follow-up group was significantly different from pre-op (p = 0.0040), but not post-op (p = 0.6833). Furthermore, post-op was significantly different from pre-op (p = 0.0089). CONCLUSION: This is an effective method of correcting and maintaining reduction until healing for this relatively rare and difficult-to-treat injury pattern.
Authors: Theodore Manson; Robert V O'Toole; Augusta Whitney; Brian Duggan; Marcus Sciadini; Jason Nascone Journal: J Orthop Trauma Date: 2010-10 Impact factor: 2.512
Authors: Rahul Vaidya; Erik N Kubiak; Patrick F Bergin; Derek G Dombroski; Ren J Critchlow; Anil Sethi; Adam J Starr Journal: Clin Orthop Relat Res Date: 2012-08 Impact factor: 4.176
Authors: R A Keshishyan; V M Rozinov; O A Malakhov; L E Kuznetsov; E G Strunin; G A Chogovadze; V E Tsukanov Journal: Clin Orthop Relat Res Date: 1995-11 Impact factor: 4.176
Authors: Rahul Vaidya; Adam Jonathan Martin; Matthew Roth; Frederick Tonnos; Bryant Oliphant; Jon Carlson Journal: J Orthop Trauma Date: 2017-05 Impact factor: 2.512