Traumatic hemipelvectomy is a rare but devastating injury involving complete disruption of the hemipelvis from the pubic symphysis to the sacroiliac joints and often results in death. We present an interesting case of traumatic hemipelvectomy caused by a previously undescribed mechanism of injury in which judicious angiography and aggressive surgical treatment contributed to patient survival.
Economic and decision analyses, level III (systematic review of level III studies). See Guide for Authors for a complete description of levels of evidence.
This study compared the graft/femoral tunnel angle produced with the outside-in technique with the inside-out technique at 90° and 120° of flexion. Three femoral tunnels were marked with guidewires and measured radiographically in 8 fresh-frozen cadaveric knees using both techniques. Results were analyzed. The mean graft/femoral tunnel angle was 34.4°614.4° for the outside-in technique, 52.3°614.1° for the inside-out technique at 120° of flexion, and 74.4°611° for the inside-out technique at 90° of flexion. The angle was smaller for the outside-in technique versus the inside-out technique at both 120° (P = .019) and 90° of knee flexion (P , .001). The outside-in technique for femoral tunnel placement produces the lowest graft/femoral tunnel angle in cadavers. With the inside-out technique, 120º of flexion produces smaller angles than does 90º of flexion. The outside-in technique results in lower angles and perhaps lower graft failure rates. However, additional clinical studies are needed. [J Knee Surg. 2009;22:106-110.]
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