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Pelvis and Acetabulum

Session: Breakout Session

What Went Wrong in Pelvic Fracture Management and How Can I Fix it?

Friday, October 20, 2023
4:30 PM – 5:30 PM PST
Location: 4B

    Moderator(s)

  • Reza Firoozabadi, MD, MA

    Associate Professor of Orthopedics and Sports Medicine
    University of Washington, Harborview Medical Center
    Seattle, Washington, United States

    Disclosure(s): Depuy-Synthes: Consultant (Ongoing); Smith & Nephew: Consultant (Ongoing)

    • Faculty(s)

  • Reza Firoozabadi, MD, MA

    Associate Professor of Orthopedics and Sports Medicine
    University of Washington, Harborview Medical Center
    Seattle, Washington, United States

    Disclosure information not submitted.

  • Adam Starr, MD

    Chief of Orthopaedic Surgery, Professor
    Parkland Memorial Hospital/UT Southwestern Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

  • Kelly A. Lefaivre, MD (she/her/hers)

    Associate Professor
    University of British Columbia
    Vancouver, British Columbia, Canada

    Disclosure(s): AONA: Grant or Research Support, or I am listed as the PI (Ongoing); Curvafix: Stock Shareholder (excluding mutual funds) (Ongoing); Zimmer Biomet: Consultant (Ongoing), Grant or Research Support, or I am listed as the PI (Ongoing)

  • HS

    H. Claude Sagi, MD

    professor
    University of Cincinnati College of Medicine
    Cincinnati, Ohio, United States

    Disclosure(s): Acumed: Consultant (Ongoing); Conexxions: ownership/equity (Ongoing); Globus: Consultant (Ongoing); GLW: Consultant (Ongoing); Stryker: Consultant (Ongoing)

  • MR

    Milton L. Routt, MD

    Professor and Andrew R. Burgess, MD Chair, Department of Orthopaedic SurgeryChi
    The University of Texas Health Science Center at Houston
    Houston, Texas, United States

    Disclosure(s): No financial relationships to disclose

  • CK

    Conor P. Kleweno, MD

    Associate Professor
    University of Washington Department of Orthopaedics
    University of Washington Orthopaedics
    Seattle, Washington, United States

    Disclosure(s): SI-Bone: Consultant (Ongoing); Stryker Medical: Consultant (Ongoing)

The purpose of this breakout session to provide healthy discussion around the topic of pelvic ring injuries that went bad. This will be a case-based discussion reviewing failed non-operative and operative management of pelvic ring injuries. The discussion will be centered around the following; what could have been done differently at the index procedure, potential reasons for failure, and how to address pelvic ring deformity post-surgery. Anterior and posterior pelvic ring fixation options will be examined in the setting of a non-union/mal-union surgery. Open versus percutaneous posterior ring injury fixation will be discussed in addition to when is lumbopelvic fixation required. Further consideration will occur in regards to bone grafting and using auto versus allo vs BMP for the sacral nonunion. Techniques for removal of broken transiliac transacral screw will be reviewed and utility of c-clamp for reduction assistance will be debated. Lastly, we will discuss postoperative course and weightbearing restrictions and does weightbearing change with type of implants used anteriorly and posteriorly.

Learning Objectives:

At the completion of this activity, participants will be able to:
  • Determine how much anterior and/or posterior fixation is required to maintain a reduction of specific pelvic ring injury patterns.
  • Identify how to treat sacral non-unions with broken hardware.
  • Describe when a relatively benign pelvic ring injury can significantly displace over time and how to treat it once you have significant deformity.