Date: Mon, 13 Sep 2004 17:18:58 -0500
From: Anglen, Jeffrey
Subject: Intrapelvic fracture dislocation of the hip
Anyone ever seen one like this before? Any suggestions on how to get that thing out of there, because I tried and couldn't -got called in to the OR by a colleague with the patient already on the fracture table and 2 big incisions ( lateral and iliac crest) already made. Gave up after an hour or two and will try again if I can figure the solution.
By the way, I ll be leaving the University of Missouri at the end of the year, and I m not sure what that means for the future of this list, but we may have to try to migrate to another server somewhere else.
Date: Mon, 13 Sep 2004 18:15:22 -0700
From: Chip Routt
Yes. We used a Watson-Jones exposure, spread the acetabular fracture with a laminar spreader, and used a Schanz pin to remove the proximal femoral fragment, then fixed it, and later fixed the acetabular fracture.
Date: Tue, 14 Sep 2004 10:48:59 -0400
From: James Carr
I have had one very similar. I placed him lateral decubitus, did a posterior approach, and did similar to what Chip described. The posterior approach allowed me to fix what appears to be a transverse acetabular fracture. The femoral neck can be fixated from that approach with multiple screws, although there may be more there than "just" a neck fx. The patient later required hemiarthroplasty for total head osteonecrosis.
I for one thank you for all the work with this trauma list, among other things.
James B. Carr, MD
Premier Orthopedic Specialists
Columbia, SC 29203