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Case Report
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.
Journal of the Korean Fracture Society 2014;27(2):151-156.
DOI: https://doi.org/10.12671/jkfs.2014.27.2.151
Published online: April 18, 2014

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: November 13, 2013   • Revised: December 31, 2013   • Accepted: December 31, 2013

Copyright © 2014 The Korean Fracture Society. All rights reserved.

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.

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  • 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.
  • 1. Kellam JF, McMurtry RY, Paley D, Tile M. The unstable pelvic fracture. Operative treatment. Orthop Clin North Am, 1987;18:25-41.
  • 2. Tile M. Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br, 1988;70:1-12.ArticlePDF
  • 3. van den Bosch EW, van Zwienen CM, van Vugt AB. Fluoroscopic positioning of sacroiliac screws in 88 patients. J Trauma, 2002;53:44-48.Article
  • 4. Matta JM, Dickson KF, Markovich GD. Surgical treatment of pelvic nonunions and malunions. Clin Orthop Relat Res, 1996;(329):199-206.Article
  • 5. Mears DC, Velyvis J. Surgical reconstruction of late pelvic post-traumatic nonunion and malalignment. J Bone Joint Surg Br, 2003;85:21-30.
  • 6. Rousseau MA, Laude F, Lazennec JY, Saillant G, Catonné Y. Two-stage surgical procedure for treating pelvic malunions. Int Orthop, 2006;30:338-341.
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.
jkfs-27-151-g001.jpg
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.
jkfs-27-151-g002.jpg
Fig. 3
Preoperative magnetic resonance imaging showing L5 nerve root, tracks inferior over the sacral wing.
jkfs-27-151-g003.jpg
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.
jkfs-27-151-g004.jpg

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        Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release
        J Korean Fract Soc. 2014;27(2):151-156.   Published online April 30, 2014
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      Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release
      Image Image Image Image
      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.
      Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release

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