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Прислано Jeff Richmond 25 Сентябрь 2007, 22:43
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Any advice would be appreciated:
40 ish female ejected from car. Unstable, DPL negative, went to angio and had her pelvic bleeds embolized after many units of blood. GCS 6, floating elbow, clavicle, bothbones, etc.
My standard approach to this pelvis would be posterior, reduce/lag/plate thecrest, reduce/plate the caudal extent on the posterior crest and 1-2 lags back to front. In this case, the crest comminution seems to make plating all
the way to the ASIS useless, as the plate would be on free floating fragments. Would plating the posterior extent of the fracture to secure the
reduction at the SI joint and 2 screws back to front be sufficient fixation? Would anyone do a perc reduction and perc back to front screws, and would that be sufficient if the SI joint could be reduced (although I don't see how this could be accurately reduced closed). Would an ilioninguinal with a pelvic brim plate and posterior column screws be a better approach, although reducing the SI would be more indirect and less accurate?
Thanks
Jeff Richmond
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