results

Vertical Shear

Vertical shear

 

Definition

 

Unstable injuries

Complete disruption of both the anterior and posterior ring

 

5 - 20% of pelvic fractures

 

Mechanism

 

Axial load

Motor vehicle accident

Fall from height

 

Pathology

 

Anterior ring

Fixation

Definition

 

Garden 1 / 2

 

Algorithm

 

ORIF

- ~ 15% displacement rate with non operative management

- increased risk of non union

- reduced hospital in patient stays

 

Options

 

Cannulated screws

DHS + derotation screw

 

3 cannulated screws

 

Central Cord Syndrome

Epidemiology

 

Most common pattern cord injury

 

Hyper-extension injury in middle aged man with osteoarthritic spine

 

Usually C3/4 and C4/5

 

Mechanism

 

Most common type / in older patient with pre-existing spondylosis / OPLL

- hyperextension injury

- compression of the cord

- anteriorly by osteophytes

- posteriorly by infolded ligamentum flavum

 

Perthes

Issues

 

Femur

 

Multiplanar deformity

- worsend by previous surgery

- may require osteotomy

 

Acetabulum

 

Dysplasia often present

- not as severe as in DDH

 

LLD

 

Can be significant

 

Abductors

 

Have been short for long time

- difficult to restore length