At many centers we give bilateral skeletal traction for unilateral disruptions.
Dear Ravi
The Young and Burgess classification system divides pelvic fractures into types by mechanism of injury. Anteroposterior compression, lateral compression, vertical shear , and combined mechanical injuries are commonly associated with high-energy trauma, such as motor vehicle acci- dents. Associated injuries are common and can be life-threatening, including pelvic hemorrhage, especially with lateral compression and anteroposterior compression injuries.
The grade III refers to the upper deviation of the hemipelvis? Injury of the sacroiliac and pubic symphysis? We do the surgery normally within 48 hours and do not use skeletal traction. When indicated traction, we used the unilateral traction with elevation of the foot of the bed
Thanks Dr Nelson!
The purpose of my asking this question was that I was never convinced with the practice of giving bilateral traction as it was more cumbersome for the patient.
In my instutution, we do the surgery normally within 24 hours and we use unilatreal skeletal traction.
Unilateral traction is logic and justified. Anyway, I agree with Nelson and Julien early surgery is the method of choice.
Hi, in our experience, we use an orthopedic table (like a Joe Matta table) to reduce opening and ascension of the iliac part. The advantage of the orthopedic table is to stabilize the opposite side in order to have a stable support to reduce the injured side. When we reduce the injured side, the healthy side does not move and make easy the reduction and fixation ! So it does not require bilateral traction, on the contrary ! Of course if we are to the case of a unilateral lesion.
I hope this can help you.
best regards
Yes we practice it. Bilateral traction will balance the pelvis with ipsilateral traction should be more than the normal side
This type of management does not achieve anything. Sacro-iliac joint disruption must be treated like any other joint: anatomical reduction plus stability. We have gained enough expertise to manage this injury surgically. Try and do the operation within ten days before fibrosis and reduction become difficult
Early surgical reduction and osteosynthesis is the method of choice. Traction should preserve for complicated cases with polytrauma that need IC, resuscitation, stabilization of the function of other important organs and surgery for life-threatening conditions. As soon as the general state allows the open sacro-iliac reduction and metallic stabilization should be done.