Transcondylar traction as a closed reduction technique in vertically unstable pelvic ring disruption

Thaunat, Mathieu; Laude, F.; Paillard, Philippe; Saillant, G; Catonné, Yves

doi:10.1007/s00264-006-0283-8

Cited by 23 publications

(21 citation statements)

References 21 publications

(15 reference statements)

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“…[3][4][5][6][7] Displaced fractures of the pelvic ring in association with vertically unstable disruption of the osteoarticular junction of the sacroiliac area may also require the management by either external fixation, percutaneous or mini-incisional screw fixation, conventional surgical exploration, or a combination of one or more of these procedures. [8][9][10][11][12][13][14] In this regard, several reports described that malunited fractures of the pelvic ring were associated with poor functional outcome. 1,4,5,11,15 In contrast, some authors described no relationship between functional outcome and major displacement of the pelvic ring.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of patients with unstable pelvic ring fracture

Kokubo

Oki

Sugita

et al. 2017

J Orthop Surg (Hong Kong)

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The purpose of this study was to evaluate factors that correlated with unsatisfactory short- and long-term outcome in patients who sustained unstable pelvic ring fracture. The study subjects of this study were those of type B and C pelvic ring fractures (82 patients; mean age 54 years). Age, gender, associated injuries, fracture type, Injury Severity Score rating and treatment methods were assessed, and Majeed score for functional outcome and radiographic studies at 1 year after injury (short-term) and at final follow-up (long-term), with mean follow-up of 98 months were analyzed. Significant univariate factors ( p < 0.05) were entered in a multivariate logistic regression model to determine the independent predictors of unsatisfactory functional outcome. Univariate analysis showed that fractures of the lower extremity, nerve damage, conservative treatment, and radiological outcome correlated with unsatisfactory short-term functional outcome, while female gender, brain injury, nerve damage, conservative treatment, fracture location at the posterior portion of pelvic ring, radiological outcome, and pure sacroiliac dislocation only for type C fracture correlated with unsatisfactory long-term outcome. Multiple logistic regression analysis identified fractures of the lower extremity (odds ratio (OR): 5.364), conservative treatment (OR: 13.690), and nerve damage (OR: 21.392) as determinants of unsatisfactory short-term functional outcome and nerve damage (OR: 66.926) and poor radiological results (OR: 33.944) as determinant of long-term functional outcome. In patients with unstable pelvic ring injury, fractures of the lower extremity, conservative therapy, and nerve damage influenced short-term functional outcome, while that nerve damage and the pelvic ring displacement over 20 mm negatively affected long-term outcome.

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Section: Introductionmentioning

confidence: 99%

Functional outcome of patients with unstable pelvic ring fracture

Kokubo

Oki

Sugita

et al. 2017

J Orthop Surg (Hong Kong)

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“…We have been operating with a radiolucent table till date while treating FFP type IIIa alone and never used a traction table for fracture reduction of this type. A study reported that longitudinal traction is useful for high-energy pelvic ring fractures with vertical instability [ 7 ]. In general, a Kirschner wire is inserted into the femur on the same side as the affected one and withdrawn to reduce it.…”

Section: Discussionmentioning

confidence: 99%

“…In general, a Kirschner wire is inserted into the femur on the same side as the affected one and withdrawn to reduce it. Thus, it is introduced as a reduction technique via transcondylar traction [ 7 ]. The present case was a fracture of the iliac wing from the greater sciatic notch, and the fracture was shortened to the caudal direction with a third bone fragment.…”

Section: Discussionmentioning

confidence: 99%

Closed reduction and minimally invasive surgical treatment of type IIIa fragility fractures of the pelvis associated with ipsilateral periprosthetic femur fracture: A case report

Yanagisawa

Watanabe

Matsumoto

et al. 2020

Trauma Case Reports

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Patients with fragility fractures of the pelvic ring (FFP) are elderly and, from the perspective of surgical invasion, percutaneous and stable fixation may be a superior surgical method than open reduction and internal fixation (ORIF). While in the case of FFP type IIIa, ORIF, as a rule, typically requires open reduction of the displaced ilium via an anterior intrapelvic approach and/or lateral window of the ilioinguinal approach. We have reported here the case of an 89-year-old woman who suffered from FFP type IIIa with ipsilateral periprosthetic femur fracture that was surgically treated. The iliac fracture was approached in a minimally invasive manner using the traction operation while preparing for femoral shaft fracture surgery, which did not require open reduction, and showed favorable outcomes.

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“…Under such circumstances, the authors propose transcondylar traction at the initial stage, which could reduce the vertical fracture-dislocation, making surgery easier at a later stage. 22 Third, the authors propose reduction of the vertically unstable crescent fracturedislocation via a posterior approach. The advantages include direct visualization and reduction of the fracture-dislocation with the help of reduction forceps.…”

Section: Discussionmentioning

confidence: 99%

Posterior Iliac Crescent Fracture-dislocation: Is It Only Rotationally Unstable?

Zong¹,

Chen²,

Jiang³

et al. 2014

Orthopedics

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Posterior iliac crescent fracture-dislocation is generally considered rotationally unstable and vertically stable. The current study (1) investigated whether vertical instability may occur in posterior iliac crescent fracture-dislocation and (2) analyzed the clinical features of vertically unstable iliac crescent fracture-dislocation as well as treatment strategies. Patients with pelvic fracture who were treated in the authors' department from June 2009 to June 2012 were retrospectively reviewed. This study analyzed the clinical features, including incidence, hemodynamic state, associated injuries, injury severity score, and treatment methods for vertically unstable iliac crescent fracture-dislocation. Four patients had vertically unstable fracture-dislocation, accounting for 12.9% of all iliac crescent fracture-dislocations. All 4 patients were hemodynamically unstable on admission and had complications of associated injuries with a higher injury severity score. In 3 of the 4 patients, iliac crescent fracture-dislocations were reduced via the posterior approach at the initial stage and these patients underwent fixation with a plate. The remaining patient was initially given transcondylar traction because of severe complications and underwent open reduction and internal fixation (ORIF) via a posterior approach at a later stage. The outcomes of all 4 patients were rated as good or excellent by the Kobbe rating system at the last follow-up. Vertical instability may occur in iliac crescent fracture-dislocation. The authors propose ORIF of the fracture-dislocation via a posterior approach. When initial surgery is not possible because of severe associated organ injuries, the authors propose transcondylar traction to allow reduction of the sacroiliac joint and ORIF at a later stage.

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Transcondylar traction as a closed reduction technique in vertically unstable pelvic ring disruption

Cited by 23 publications

References 21 publications

Functional outcome of patients with unstable pelvic ring fracture

Functional outcome of patients with unstable pelvic ring fracture

Closed reduction and minimally invasive surgical treatment of type IIIa fragility fractures of the pelvis associated with ipsilateral periprosthetic femur fracture: A case report

Posterior Iliac Crescent Fracture-dislocation: Is It Only Rotationally Unstable?

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