NM Fitzpatrick, KL Perry, J O’Riordan, R Yeadon.
Fitzpatrick Referrals, Farnham, United Kingdom

ACVS Abstract 2007 

No single technique has been universally applied to all pelvic fracture configurations. Our objective was to document application and outcome using a biologic approach and ESF.

ESF was employed for 156 cases of pelvic fracture and/or sacro-iliac (SI) luxation. SI joints and ilial fractures were accessed bilaterally via a dorsal midline incision. SI congruity was restored using pins placed through the ilial articular surface into the sacral auricular surface acting as a reduction guide (Pin Anchor Slide Technique, PAST). Sequential realignment of fracture segments was achieved using 2–4 pins per segment on connecting rods and attaching segments using link rods (Pin Anchor Realignment Technique, PART).

Dorsal articulating rods connected components. Radiographs were reviewed and VAS function questionnaires completed. Mean time to frame removal was 4.8 weeks (cats) and 5.9 weeks (dogs). Mean % reduction was 82% (cats) and 92% (dogs) for SI luxation, and 83% (cats) and 89% (dogs) for sacral fractures. Mean pelvic diameter ratios were 95% (cats) and 104% (dogs). Mean hemipelvic canal width ratios were 97% (cats) and 92% (dogs). Average VAS scores were 87/100 (cats) and 84/100 (dogs). VAS scores for 14 acetabular fractures demonstrated owner satisfaction. Complications included pin loosening, impact causing implant dislodgement, obstipation, myiasis and discospondylitis.

Versatility allowed application for all fracture/luxation corrections. PAST and PART facilitate SI realignment and fracture stabilisation in accordance with biologic osteosynthesis. Fragment manipulation was facilitated by digital guidance through dissection windows and accurate pin placement. Reconstruction accuracy and clinical outcome bear favourable comparison to previously published techniques.