Pelvis, acetabulum: displaced right T-type acetabular fracture—62-B2, and associated bilateral sacral fractures and left iliac wing fracture

10.1055/b-0034-87628

Pelvis, acetabulum: displaced right T-type acetabular fracture—62-B2, and associated bilateral sacral fractures and left iliac wing fracture

Zhiyong Hou, Wade R Smith

Case description

A 22-year-old man sustained a displaced complicated pelvis fracture following a motor vehicle accident: T-type acetabular and associated bilateral sacral fractures, and left iliac wing fracture.

Indication for MIPO

Although the right T-type acetabulum and bilateral sacral are nondisplaced fractures, operative treatment of the pelvis was indicated in this complicated pelvis fracture for rehabilitation reasons. Percutaneous long screw placement is a good option in this case and can be performed with MIPO technique.

a–i Preoperative AP (a), outlet (b), inlet (c), right obturator oblique (d), and right iliac oblique (e) projections of the pelvis and hips show a minimally displaced T-type fracture of the right acetabulum and a displaced, comminuted fracture of the lateral aspect of the left iliac bone above the level of the left hip. CT scans (**f–i**) show bilateral sacral fractures and no diastasis of the sacroiliac joint or pubic symphysis is visualized. A pelvic trauma orthotic device was placed initially.

Preoperative planning

Following initial assessment, the patient was in good condition for operative fixation of his pelvic fractures on the second day after admission. After the decision was made that the case was suitable for MIPO, a thorough preoperative plan including the displacement of the fracture fragments, the reduction technique, the surgical approach, and selection of the appropriate implants was performed ( Fig 15.4-2 ).