Supra-Acetabular & Iliac Crest Pelvic Ex Fix

• Objectives– To define & describe the principles of pelvic

ring stability obtained with external fixation.– To apply a supra-acetabular pelvic external

fixator construct.– To apply an iliac crest pelvic external fixator

construct.– To differentiate the advantages &

disadvantages of a supra-acetabular frame compared to an iliac crest frame.

Principles Of Pelvic Ring Stability Obtained With External Fixation

• Pelvic ex fix may serve as an adjunct to resuscitation

• Complete (or partial) immediate pelvic ring mechanical stability

• Some pelvic ring deformities will not be rendered “stable” with pelvic ex fix alone

• Application can aide reduction in some ring injuries

• Pelvic ex fix can be definitive treatment in some pelvic ring injuries

Supra-Acetabular Ex Fix

• Ex fix pin placed at AIIS in the bone corridor from the anterior column toward the posterior column

• Pin runs in a “supra-acetabular” direction

• 5 or 6 mm pin ~200 – 350mm in length

• 1 or 2 pins on each side

• Single bar is acceptable, provided abdominal clearance

Supra-Acetabular Ex Fix

Outlet Obturator Oblique

Iliac Oblique

Inlet Obturator Oblique

Iliac Crest Ex Fix

• Ex fix pin placed at gluteal tubercle in the bone corridor from iliac crest toward the acetabulum

• Pin runs parallel to the tables of the ilium

• 5 or 6 mm pin ~200 – 350mm in length

• 1-3 pins on each side

• Usually 2-3 bars, must provide abdominal clearance

Iliac Crest Ex Fix

Iliac Crest Ex Fix

Lab Equipment

• Sawbone Model – – Diastasis & SI

Disruption #1301-21

• Reduction Clamps– Weber – Pointed

Reduction– Jungbluth – Screw

Reduction Clamp

• Implants– Small Frag Set w/

Long Screws (at least 40-60 mm)

– 4 – 6 hole pubic plate or recon plate

• Equipment– Drill / Driver– Recon Bending Pliers