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  • Percutaneous Pelvic Fracture Fixation

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    AkimuMageza
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    Percutaneous pelvic fracture fixation is an increasingly common technique for treating pelvic fractures. It requires specialized skills and equipment to reduce and fixate fractures using long cannulated screws placed percutaneously under fluoroscopy or CT guidance. Key advantages over open fixation include lower complication rates, shorter surgical time, and avoiding morbidity of open approaches. Careful patient evaluation, fracture reduction, and understanding of pelvic anatomy are essential for successful percutaneous pelvic fixation.

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    Percutaneous Pelvic fracture fixation

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    Percutaneous pelvic fracture fixation is an increasingly common technique for treating pelvic fractures. It requires specialized skills and equipment to reduce and fixate fractures using long cannulated screws placed percutaneously under fluoroscopy or CT guidance. Key advantages over open fixation include lower complication rates, shorter surgical time, and avoiding morbidity of open approaches. Careful patient evaluation, fracture reduction, and understanding of pelvic anatomy are essential for successful percutaneous pelvic fixation.

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    12 views14 pages

    Percutaneous Pelvic Fracture Fixation

    Uploaded by

    AkimuMageza
    Percutaneous pelvic fracture fixation is an increasingly common technique for treating pelvic fractures. It requires specialized skills and equipment to reduce and fixate fractures using long cannulated screws placed percutaneously under fluoroscopy or CT guidance. Key advantages over open fixation include lower complication rates, shorter surgical time, and avoiding morbidity of open approaches. Careful patient evaluation, fracture reduction, and understanding of pelvic anatomy are essential for successful percutaneous pelvic fixation.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 14

    Percutaneous Pelvic fracture fixation

    Mr A C Mageza
    MBChB (UZ) FCS Orth (ECSA)
    Historical perspective

    • Non operative mx
    • Chronic pain & disability
    • Complex if not impossible to do reconstructive work
    • Associated with poor outcomes following THA

    • The scope of P&A surgery is increasing

    • Outcomes improving
    The Burden of P&A work

    • ⇧ in P& A work

    • ➚ number of trauma survivors ➚No. geriatrics

    • Fewer Pelvic & Acetabular Surgeons world wide

    • Involving surgery

    • Specialised equipment

    • Though understanding of the 3D anatomy of the pelvis


    Evaluation of the pt
    • ATLS - polytrauma

    • History

    • Head to toe examination

    • Pelvic spring test

    • Neurological exam
    • Perianal sensation
    • Anal tone

    • Bulbocavenosus reflex

    • Morel Lavalle lesion


    Management

    • Non Operative
    - Stable fracture

    - Neurologically intact with No or


    • Operative
    minimum displacement

    -✴Insufficiency fractures
    Closed reduction
    - Bed rest- traction
    ✴Open reduction
    - Pelvic binder
    - Ex fix
    Operative management

    • Closed reduction + percutaneous fixation

    • Open reduction + Percutaneous fixation

    • Open reduction + internal fixation

    • Combination
    Indications for operative fixation

    • Unstable injuries

    • Displacement >10mm

    • Neurological involvement

    • Soft tissue compromise

    • Failed non-operative management


    Percutaneous fixation - requirements

    • Knowledge of anatomy of the pelvis and its variations

    • Preoperative planning

    • Fluoroscopy or intraop CT scan

    • Long cannulated screws

    • Ability to reduce the fracture

    • Can combine percutaneous fixation with ORIF


    Fracture reduction

    • Closed reduction
    • Manual traction/ manipulation

    • Traction table

    • External fixator
    • Shunt pins

    • Screw reduction

    • Open reduction
    Case example 63y/m tractor accident
    Conclusion
    • Percutaneous fixation of pelvic fractures becoming popular

    • Needs a thorough understanding of the 3D pelvic anatomy

    • Perfect reduction is a pre-requisite

    • Shows better results compared to open tech

    • Lower complication rates

    • Shorter surgical time

    • Avoids the morbidity associated with open technique

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