Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release

Kwang-Cheon Choi; Ji-Yoon Ha; Weon-Yoo Kim

doi:10.12671/jkfs.2014.27.2.151

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Choi, Ha, and Kim: Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release

Case Report

Journal of the Korean Fracture Society 2014; 27(2): 151-156.

Published online: 18 April 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.2.151

Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release

Kwang-Cheon Choi, M.D., Ji-Yoon Ha, M.D., Weon-Yoo Kim, M.D.

Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Daejeon, Korea.

Address reprint requests to: Weon-Yoo Kim, M.D. Department of Orthopedic Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital, 64 Daeheung-ro, Jung-gu, Daejeon 301-723, Korea. Tel: 82-42-220-9530, Fax: 82-42-221-0429, weonkim@hotmail.com

Received 13 November 2013 Revised 31 December 2013 Accepted 31 December 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nonunion of an unstable pelvic fracture with cranial displacement pelvic surgery is technically difficult due to a large amount of bleeding and the risk of nerve damage. In addition, surgical correction of leg length discrepancy by reduction of a dislocated sacroiliac joint is in high demand. Nevertheless, when a patient is strongly disabled by a pelvic deformity, surgical correction may be necessary. Two patients with pelvic deformity were treated successfully by surgical correction and osteosynthesis.

Keywords: Pelvic bones, Leg length unequiality, Ununited fractures

Figures and Tables

Fig. 1

(A) Initial post-accident computed tomography scan showing both a rami fracture and a left sacral wing fracture (Tile type C). (B) Pelvic reduction and stabilization with anterior pelvic external fixator only. (C) Six months after the accident, simple radiographs showing superior migration of the left hemipelvis and nonunion of the fracture site. (D) Simple radiographs after surgical correction showing decreased cranial displacement.

Fig. 2

(A) Approximately 3 cm cranial displacement of right hemipelvis. (B) One year after surgical correction, simple radiographs showing anatomical reduction and bony union.

Fig. 3

Preoperative magnetic resonance imaging showing L5 nerve root, tracks inferior over the sacral wing.

Fig. 4

(A) Postoperative computed tomography (CT) scan showing that the S1 sacroiliac screws lie on a safety zone, angled 10 degrees anteriorly. (B) Postoperative CT scan showing that the S2 sacroiliac screws lie on a safety zone, parallel to the floor.

Notes

Financial support: None.

Conflict of interest: None.

References

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