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. 2022 Dec 30:37:102091.
doi: 10.1016/j.jcot.2022.102091. eCollection 2023 Feb.

Use of calcaneal plates in the treatment of posterior pelvic ring injuries and displaced iliac blade fractures- A case series

Zakir Hussain  1 , Siddharath Sharanappa Parmeshwar  2 , Amit Jain  1 , Abhishek Chandra  3
Affiliations

Use of calcaneal plates in the treatment of posterior pelvic ring injuries and displaced iliac blade fractures- A case series

Zakir Hussain et al. J Clin Orthop Trauma. .

Abstract

Introduction: The operative fixation of pelvic ring injuries and associated acetabulum fractures presents a challenging scenario to most of the orthopaedic trauma surgeons. Current development of anatomically contoured reconstruction (ACR) plates gained popularity in fixing complex pelvic ring fractures. This study was done to assess the functional and radiological outcomes using of lateral wall stainless steel (LWSS) calcaneal plates in posterior pelvic ring injuries and displaced iliac blade fractures.

Materials and methods: Retrospectively selected eight cases of pelvic ring injuries planned for fixing posterior pelvic instability and iliac blade fractures using LWSS plates. Mean follow-up was 18 months (Range 12-26 months).

Results: Average time for radiological bony union achieved in 18 weeks (Range 13-22). Seven patients returned to their normal work. Average Majeed score was 60 (Range 50-68). Mean duration of surgery was 160 min (Range 120-200).

Conclusion: This technique can be routinely used as supplementary fixation for posterior pelvic ring instability and iliac blade fractures. LWSS calcaneal plates showed no screw breakage or implant failure. Further this technique was cost effective in developing countries with limited resources.

Keywords: Acetabulum fractures; Anatomically contoured recon plates; Lateral wall stainless steel calcaneal plates; Majeed score; Pelvic ring injuries.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Diagrammatic representation of application of calcaneal plate in SI joint disruption (a) and displaced iliac blade (b).
Fig. 2
Fig. 2
Case 1, a) and b) preoperative x-ray and 3DCT scan showing Young Burgess LC Ⅱ injury with anterior wall of acetabulum fracture, c) Immediate postoperative x-ray image showing LWSS calcaneal plate fixing iliac blade and ACR plates stabilising anterior wall of acetabulum and anterior pubic instability.
Fig. 3
Fig. 3
Case1, a) X-ray at 3rd month postoperative period showing stable reduction with no screw loosening, b) X-ray at 12th month postoperative period showing complete bony union.
Fig. 4
Fig. 4
Case1, Clinical images at 20th month follow-up a) showing normal limb active straight leg raising, b) showing single leg weight bearing on normal side, c) showing decreased active straight leg raising of injured side, d) showing single leg weight bearing on affected side, e) showing cross leg sitting f) showing squatting position.
Fig. 5
Fig. 5
Case 1, a) and b) 3DCT cut section showing bony union at 20th month, c) X-ray at 20th month post-operative period showing complete union of iliac blade and acetabulum, d) 3DCT image at 20th month follow-up.
Fig. 6
Fig. 6
Case 2, Postoperative x-ray showing LCSS plate stabilising SI joint instability and ACR pelvic plates (6 holes) stabilising pubic diastasis.
See this image and copyright information in PMC

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