Ch 56 - Fractures of the Pelvis Flashcards
What % of pelvic fractures have fractures at three or more sites in the pelvis?
76%
What percentage of pelvic fractures affect the weight bearing axis?
Bilateral weight bearing axis?
Unilateral 89%
Bilateral 39%
What % of pelvic fractures have urinary tract trauma?
How many require surgery?
39%
16% require surgery
What is the most common cause of neuro injury secondary to pelvis fractures?
How many have permanent neuro dysfunction?
Injury to the lumbosacral trunk associated with craniomedial displacement of iliac fractures (91%)
15% permanent
Do caudal acetbaular fractures need surgical fixation?
Controversial
- Animals seem to weight bear and be more comfortable than with other acetabular fractures
- Two studies have demostrated that the caudal acetabulum DOES have a important weight-bearing role
- Long term follow up of conservatively managed cases has shown unsatisfactory results for lameness and pain associated with significant DJD
- Often difficult to reduce and stabilise
What is the common obliquity of ilial fractures?
Cranioventral to caudodorsal
Usually cranially and medially displaced
What are some techniques of reducing ilial fractures?
- Direct fragment manipulation
- Gentle leveling
- Lifting proximal femur
- Separateapproach to tuber ischii and use of a Kern bone-holding forcep
- Using the implant
- Forceps sliding maneuver
What are the surgical options for ilial fractures?
- Bone plating (lateral, dorsal, ventral)
- ESF
- Lag screws
- Composite fixation
Dorsal plating in cats has shown less screw loosening and less canal narrowing
Plates: 2.7mm cats/small dogs, 2.7-3.5mm medium/large dogs)
What is secondary acetabular protrusion?
Medial luxation of the femoral head inside the pelvic canal following acetabular fracture
What is the prognosis for acetabular fractures?
generally very good!
- 83% occassional or no lameness
- 83% reduced mid-thigh circumference
What % of SI luxations are bilateral?
- 23% in dogs
- 18% in cats
What are the fixation options for SI luxations?
- Lag screw
- Transiliosacral rod or screw
- Transilial pinning
- Pin and tension band
- Ventral screw placement
Where is the ideal location of the screw in the sacral body?
Inserted at what angle?
Inserted at 100 +/- 4.7 degrees in dogs
97 +/- 6.9 degrees in cats
What are the landmarks for screw placement in the wing of the ilium for a SI lag screw?
What is the recommend screw size for SI lag screw?
- 2.0/2.7mm cats and small dogs
- 3.5/4.0mm for medium dogs
- 4.5/6.5mm for large dogs
