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Re: Acetabular Fx Surgical Approach
послал Dan Schlatterer 15 Июль 2006, 23:49
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good morning,
the case that I found is a 20yo male, MCC. his AP pelvis shows an interesting position of his bladder. it is pushed aside by a hematoma from SGA injury. we did a limited lateral window approach for the anterior column first, pt bumped up/supine. then closed and repositioned for KL. I could not find intra-op photos of cases when we did only a small incision for the AC screw (but they do exist!!). the lateral window is available for reduction assessment if a KL approach is being used. in the lateral position this window is available. the prone position definitely takes pressure off of the post column and facilitates reduction. in the lateral position a schantz pin in the ischial tub +/- bone hook in sciatic notch helps with PC reduction. the lateral position also gives better airway access for anesthesia. airway problems are rare, but prone position seems to be a bit more of a challenge to exchange the tube, or reintubate altogether. just something further to debate!
dan schlatterer
atlanta
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