The Pelvic Fixator is an adjustable link system for rapid pelvic stabilisation.
The major threat from pelvic ring injuries is blood loss, the source being a variable combination of arterial bleeding, venous bleeding and bleeding from cancellous bone. As a general rule, an unstable pelvic ring is best stabilized as soon as possible and the benefit of external fixation is that it is minimally invasive and can be applied rapidly. Once stabilisation is achieved, the patient can then be moved and turned for further diagnostic measures if indicated. In comparison with internal fixation techniques, the benefit of rapid application outweighs the minimal inconvenience. It reduces the pelvic volume and produces an excellent tamponade effect. The possibility of persistent bleeding must be considered, and carefully monitored after application of the fixator.
For anterior open book type injuries, external fixation is intended as a definitive treatment and not as a temporary measure. For more extensive injuries causing anterior and posterior instability, external fixation provides excellent initial stabilisation and reduces the pelvic volume. After resuscitation and stabilisation, definitive posterior fixation can be carried out. The anterior fixation can also be definitive in this situation, with fixator removal at around eight weeks.
stabilisation with the Orthofix Pelvic Fixator is achieved by means of self-drilling screws inserted into the pelvis, and a fixator assembly which consists of two primary links joined by a connector unit. The simplicity of the system eases handling of the fixator and the ball-joints facilitate fracture reduction. Furthermore, the sliding link system allows the fixator to cover a wide range of pelvic sizes, thus significantly reducing the inventory.
The bone screws can be placed anteriorly in the hard bone above the acetabulum. This position is biomechanically very stable, and allows abdominal exploration without removing the fixator. Alternatively the screws can be placed independently in the iliac crest, care being taken to ensure that the screws are in good bone. The full technique is described in the operative technique and shown clearly in the video. The latter is included in the CD ROM containing the Applications by Anatomical Site and the Catalogue.
- Definitive stabilisation of anterior instability (open book injuries)
- Emergency stabilisation of complete pelvic instability, allowing resuscitation and stabilisation before definitive fixation
- Assures pelvic stabilisation with a minimally invasive procedure
- Permits rapid application
- Provides definitive treatment
- Reduces inventory as it covers a wide range of pelvic sizes