Pelvic Fractures

Question 1

Pelvic fractures

Answer 1

Can be managed without surgery. High energy trauma

Worry about uroabdomen in 24-38 hours

Question 2

Concurrent injuries

Answer 2

Internal organ damage, neurologic dysfunction, traumatic hernia, concurrent musculoskeletal injuries

Question 3

Considerations for surgery

Answer 3

1. Obstipation
   
   2. Neurological dysfunction- sciatic nn (withdraw of lateral digit)
      Acute- rarely have problems
      These dogs are extremely painful
      Must warn the owner
   3. Free floating acetabular segment
      Weight bearing compromised
   4. Acetabular fracture- degenerative joint disease

Question 4

Sacroiliac fracture

Answer 4

Need to address is dependent on the degree of displacement, acetabular coverage of the femoral head and concurrent injuries determine need to intervene
38% failure, but screws in sacral body have lowest incidence.

Question 5

Sacroiliac fracture fix

Answer 5

Cumulative screw depth/ sacral width >60%
Two screws stronger than 1
Adjunctive pin provided no significant strength

Approach dorsally, go between ilium and sacrum. Lever the ilium away with the retractors and looking down at sacrum, will see cartilage because it is a joint

Question 6

Ilial fractures

Answer 6

Stabilization allows transfer of weight from the hind limb to the vertebral column.
Ventrolateral approach to the hemipelvis.
Can perform trochanteric osteotomy if fixation needs to extend dorsal and caudal to the acetabulum

Question 7

Ilial fracture repair

Answer 7

Plate types include dynamic compression, veterinary cuttable, semitubular, reconstruction (Long oblique or segmental), locking plates

Question 8

Acetabular fractures

Answer 8

Anatomic and rigid internal fixation to mitigate the development of degenerative joint disease and promote primary healing
Dorsal approach via trochanteric osteotomy.
Screw/wire/polymethyl-methacrylate composition fixation: faciliates anatomic reduction, simplifies implant application, and few complications