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Re: APC III pelvis advice
послал Jeff Brooks 28 Сентябрь 2006, 20:10
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Here are the postop fluoros.

First exposed symphysis & clamped w/Faraboeuf as close to anatomic as possible.
Then extended to R ilioinguinal,really just the lateral window.
Reduced the triangular wedge piece of iliac wing to posterior intact ilium (crescent), held w/k-wire, then used 3-hole push plate to keep from moving, lagged from lat-med w 3.5 screw.
Then 6-hole plate along brim with 1 screw in R sacral ala. Then lagged 2 screws along crest A --> P. finally 10-hole plate along inner aspect of crest. R posterior ilium still a bit stepped off.
Symphysis then 'fine-tuned' & reduced as close as possible to anatomic (but, still with forward rotation of R hemipelvis - or, is it extension?) Accepted that amount of deformity and plated symph
with 4-hole symphyseal plate.
Fluoroed L SI joint and it seemed stable, but wide. So, applied c-clamp to try to squeeze down L SI joint (and note, on the last slide attached, that it's still wide), and got it closer. Single perc Iliosacral screw 40mm thread.
Applied second plate anteriorly on symphysis as I wasn't confident L SI was as stable as it could be and wanted to protect it better.
Thoughts? Thanks for the advice, it's appreciated.
Jeff
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