Name of the Procedure:

Open Treatment of Iliac Spine(s), Tuberosity Avulsion, or Iliac Wing Fracture(s)

Summary

This procedure involves surgically repairing fractures of the pelvic bone either on one side (unilateral) or both sides (bilateral). These fractures do not disrupt the pelvic ring, and the procedure may include the use of internal fixation devices such as screws or plates to stabilize the bone.

Purpose

The procedure is designed to address fractures in the iliac spine, tuberosity avulsion, or iliac wing. The goals are to stabilize the fracture, relieve pain, and restore function to the affected area, enabling patients to return to their daily activities.

Indications

• Severe pelvic pain due to fractures of the iliac spine, tuberosity avulsion, or iliac wing
• Evidence of bone instability from diagnostic imaging
• Inability to bear weight on the affected side(s)
• Failure of conservative treatments like rest and medication

Preparation

• Fasting for at least 8 hours prior to the procedure
• Adjustment or temporary cessation of certain medications, especially blood thinners
• Pre-operative blood tests, X-rays, or CT scans to assess the extent of the fracture

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: A surgical cut is made over the fracture site.
3. Reduction: The bones are aligned into their normal position.
4. Internal Fixation: Screws, plates, or other devices are used to hold the bone fragments together.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes about 2 to 3 hours, depending on the fracture's complexity.

Setting

The surgery is usually performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and technicians

Risks and Complications

• Common Risks: Infection, bleeding, and blood clots
• Rare Risks: Nerve damage, nonunion (failure of the bone to heal), and hardware-related problems like loosening or breakage

Benefits

• Stabilization of the fracture
• Reduction in pain
• Improved mobility and functionality
• Reduced risk of long-term complications like malunion (healing in the wrong position)

Recovery

• Hospital stay of several days post-surgery for monitoring
• Pain management with medication
• Physical therapy to regain strength and mobility
• Full recovery typically takes 3 to 6 months, with gradual reintroduction to normal activities

Alternatives

• Non-Surgical: Rest, physical therapy, and pain management; may be appropriate for less severe fractures.
• Minimally Invasive Techniques: Percutaneous fixation, but not suitable for all fracture types.

Patient Experience

Patients will be under general anesthesia during the procedure, meaning they will be asleep and feel no pain. Post-procedure, they may experience pain and swelling at the incision site, managed with medication. Physical therapy will help regain movement and strength, and follow-up appointments will monitor healing progress.