Pelvic Fractures

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Pelvic Fractures

Shawn C. Kennedy

Pelvic fractures in the dog and cat represent approximately 20–30% of all fractures and are usually associated with severe trauma [1, 2]. Surgical therapy is focused on important structural fractures, such as fractures causing significant pelvic canal collapse, fractures disrupting load transmission from the limb to the spine, and disruption of the continuity of the articular surface of the acetabulum with subsequent instability. The presence of significant pain and neurologic dysfunction are also indications for repair. Generally, pelvic fractures are repaired if involving the ilial body, acetabulum, and/or sacroiliac joints. Locking plates are particularly well‐suited for treatment of comminuted ilial body fractures, acetabular fractures associated with ilial body fracture, supracotyloid fractures, young patients with “soft” bone, and patients with poor mineral bone density.

The pelvis is a continuous osseous box composed of an ilium, ischium, pubis, and acetabulum on each side. Fractures generally displace if three or more bones are involved or if the sacroiliac joint(s) is involved; in immature patients, two fractures can be present because of the elasticity of the bone. Not all ilial body fractures are simple transverse or oblique fractures, in which reduction and compression is an excellent way to repair the fracture quickly. Frequently, a surgeon will be presented with a supracotyloid fracture (small distal ilial fracture cranial to the acetabulum) or with a small fragment of the cranial aspect of the ilial wing available for screw purchase. Fortunately, comminuted ilial fractures are not common (approximately 16%) because open repair and anatomic reconstruction is difficult [3]. Locking plate technology allows for a more biologic repair compared to traditional anatomic reduction and compression with dynamic compression plating (DCP) systems (Table 17.1).

Table 17.1 Comparison of veterinary locking systems in regards to properties important to pelvic fracture repair.

Locking or nonlocking screws Axial compression Variable or fixed‐angle screws Three‐dimensional contour
Synthes LCPa Both same hole Yes Fixed Yes, reconstruction only
Orthomed SOPb Locking only No Fixed Yes
Veterinary instrumentation Both Variable Fixed Yes, reconstruction only
Securos PAXc Locking only No Variable Variable
Kyon ALPSd Both same hole Yes Variable for regular screws and fixed for locking screws Yes
Traumavet Fixin Locking only No Fixed No

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Jun 13, 2021 | Posted by in SUGERY, ORTHOPEDICS & ANESTHESIA | Comments Off on Pelvic Fractures

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