Executive Editor: Peter Trafton

Authors: Rahul Banerjee, Peter Brink, Matej Cimerman, Tim Pohlemann, Matevz Tomazevic

Pelvic ring - Unilateral complete distruption posterior arch through SI joint

back to skeleton

Glossary

General considerations

Before proceeding with definitive repairs, the patient must be fully resuscitated, fully evaluated, and fit for anesthesia and surgery by a prepared team.

These patients are at risk of persistent pain, deformity, and possible nonunion. Anatomic reduction and stable fixation of both posterior and anterior injuries is necessary. Various anterior pelvic arch injuries are possible. Their reduction and fixation helps restore pelvic alignment, and adds to the stability of the essential posterior repair.

External fixation and traction
Main indication Skill Equipment
Unstable pelvic injury without availability of posterior ring fixation Some specialized surgical experience Basic equipment only

Indications

  • Unstable pelvic injury without availability of posterior ring fixation
  • Proximal displacement of the involved hemipelvis or risk thereof
  • Need to delay definitive surgery because of patient's condition

Contraindications

  • Skeletal traction should not be applied if the involved hemipelvis is distally and/or anteriorly displaced. A circumferential wrap should be applied.
  • Availability of comprehensive pelvic ring fixation without excessive delay
Operative treatment
Main indication Skill Equipment
All unilateral complete distruption injuries of the posterior arch through the SI joint Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Before proceeding with definitive repairs, the patient must be fully resuscitated, fully evaluated, and fit for anesthesia and surgery by a prepared team.

Indications

  • Unilateral unstable complete injury through the SI joint
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2015-12-10