Abstract
Aim: To establish a method of emergency and definitive stabilisation of Type C pelvic ring injuries.
Methods: Patients with pelvic ring disruption were treated acutely, using instrumentation developed by Dr. Charles Reinert. Patients were positioned supine on a radiolucent operating table configured to allow the C-arm of an image intensifier to swing through an arc sufficient to allow pelvic inlet and outlet views of the pelvis. The unstable hemipelvis was reduced by means of longitudinal traction on the leg and lateral compression with a spiked, long handled, cannulated guide. Guide wires could be positioned accurately through the guide, allowing accurate placement of AO 7.3 mm cannulated iliosacral screws, by minimally invasive percutaneous techniques.
Results: Successful acute biomechanical pelvic stabilisation was achieved in all cases. After a short learning curve, the procedure could be completed in 20 minutes.
Discussion: Previously, pelvic stabilisation was often achieved by initial, tentative stabilisation using pelvic slings, traction and external fixation, with or without later definitive fixation. Using minimally invasive techniques, rapid, emergency stabilisation can be achieved, with sufficient stability to equally suffice for definitive fixation. The minimally invasive, percutaneous technique provides greater safety for treatment of patients with early coagulopathy.
Conclusions: Acute, rapid and definitive stabilisation of type C pelvic ring disruption can be achieved by minimally invasive, percutaneous techniques using the Reinert instrumentation.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
