AOTrauma Webinar:  Why Do Patients Get Infection?

May 30, 2017 14:00 CET

Main Presenter: Olivier Borens, MD (Switzerland)
Chat Moderator: Stephen Kates, MD (USA)

Surgical site infections after trauma are debilitating and costly. They are feared by the surgeon and the patient alike. The incidence of this complication can be decreased by proper preoperative, intraoperative, and postoperative management.
The goal of this webinar is to present easy-to-use tools and strategies that will lead to a decrease in the incidence of infection.

More information and registration...

Infection

Executive Editor: Peter Trafton

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

Pelvic ring - A2.1 ORIF; iliac crest

back to skeleton

Glossary

1 Introduction top

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Pure iliac crest fractures do not compromise the stability of the pelvic ring and are mainly treated conservatively.

Open reduction and fixation is normally performed in cases when:

  • persistent pain (does not subside within 1-3 weeks)
  • X-rays show increasing displacement
  • there is significant displacement in active and healthy patients

Great care should be taken to exclude acetabular fractures and unstable pelvic injuries.

The anterior approach to the iliac wing is used. However, stripping of muscles should be kept to a minimum.

2 Reduction top

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Reduction is performed under direct vision using either a reduction forceps or Schanz screws as joysticks.


In comminuted fractures, anatomic reduction is not necessary. The basic shape of the iliac wing should be reconstructed.


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Temporary fixation is obtained by insertion of K-wires.

3 Fixation top

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A 3.5 mm reconstruction plate is contoured to fit the individual anatomy of the superior part of the iliac crest (green dotted line).

The bone stock of the central fossa is too thin to allow for adequate purchase of screws.


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The plate is placed and fixed with screws.


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Alternatively, long 3.5 mm screws placed between the tables of the superior ala can be used. These trans-iliac screws can be further supplemented with plate fixation.


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Final X-rays

After completion of internal fixation, confirm the final reduction and hardware position intraoperatively by AP, inlet and outlet radiographic imaging.

v1.0 2015-12-10