Palisade Technique — the New Method for Open Reduction of Pelvic Fractures

Abstract

Background. Restoration of the pelvic bones and acetabulum anatomy after fracture is an important criterion for functional outcome. Often, the reduction of flat pelvic bones is not an easy task. The authors proposed a method of reduction using a special support site of two or three 3.5 mm cortical screws for Matta bone forceps. The aim of the study was to demonstrate a new way of pelvic bones fragments reduction. Method Description. Three clinical situations are presented when a new method was used: 1) reduction of a pointed fragment of the acetabulum posterior column transverse fracture; 2) reduction of the acetabulum quadrilateral plate fragments with medial displacement and 3) reduction the rupture of the pelvic bones in the sacroiliac joint with the vertical displacement. Previously, a support site was created in one of the fragments from two or three not fully twisted 3.5 mm cortical screws. One of the Matta bone forceps branches was placed on the formed site, and the second on another fragment and the displacement was eliminated. Then the final osteosynthesis was performed with pelvic plates and/or cannulated screws according to the surgical plan. Before closing the wound the support site was removed. Conclusion. The proposed method has shown its effectiveness during the reduction of the flat bones fragments, as it allows you to compress the spongy bones of the pelvis with a thin cortical layer stronger, compared with existing methods during which fragments splitting and pulling out anchor screws in the branches of reduction forceps can occur. The developed method of reduction demonstrated convenience and reliability.

Keywords

• pelvic fracture
• reduction
• pelvic fracture osteosynthesis
• acetabular fracture osteosynthesis
• ilio-sacral joint dissociation