Name of the Procedure:

Open Treatment of Posterior Pelvic Bone Fracture and/or Dislocation

Summary

This procedure involves surgically repairing fractures or dislocations in the posterior region of the pelvic bone. It addresses complex breakages and dislocations that affect the pelvic ring, including the ilium, sacroiliac joint, and sacrum. The surgery may include internal fixation to stabilize the pelvic bones.

Purpose

The primary goal of this procedure is to treat severe fractures and dislocations of the pelvic bones that disrupt the pelvic ring. It aims to realign and stabilize the bones, ensuring proper healing and restoring normal function. This procedure helps alleviate pain, restores mobility, and prevents future complications from improperly healed fractures.

Indications

• Severe pelvic fractures or dislocations disrupting the pelvic ring.
• Unilateral or bilateral pelvic injuries affecting the ilium, sacroiliac joint, and/or sacrum.
• Patients with significant pain, immobility, or deformity due to the fracture.
• Fractures that have not responded to conservative treatment options.

Preparation

• Patients may need to fast for several hours before the procedure.
• A thorough medical history and physical examination will be conducted.
• Preoperative imaging studies (e.g., X-rays, CT scans) to assess the extent of the injury.
• Blood tests and possibly an electrocardiogram (ECG) to ensure the patient is fit for surgery.
• Adjustments to medications may be required, particularly blood thinners.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: A surgical incision is made over the affected area of the pelvis.
3. Realignment: The surgeon realigns the fractured or dislocated bones.
4. Internal Fixation: Metal plates, screws, or rods are used to secure and stabilize the bones.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 2-4 hours, depending on the complexity of the fractures and dislocations.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technologists
• Post-Anesthesia Care Unit (PACU) Nurses

Risks and Complications

• Infection of the surgical site.
• Blood clots or deep vein thrombosis (DVT).
• Damage to surrounding nerves or blood vessels.
• Anesthesia-related risks.
• Potential non-union or malunion of the bones.
• Hardware failure or need for revision surgery.

Benefits

• Stabilization and proper alignment of pelvic bones.
• Pain relief.
• Improved mobility and function.
• Lower risk of complications from improperly healed fractures.

Recovery

• Hospital stay for several days post-surgery.
• Pain management with medications.
• Instructions for wound care and activity restrictions.
• Physical therapy to aid in recovery and restore strength.
• Follow-up appointments to monitor healing.
• Full recovery may take several months.

Alternatives

• Non-surgical treatments like bed rest, pain management, and physical therapy.
• External fixation using a frame outside the body to stabilize bones.
• Pros: Less invasive, lower initial risks.
• Cons: Potential for longer immobility, may not be effective for severe fractures.

Patient Experience

• The patient will be under general anesthesia during the procedure and should not experience pain.
• Postoperative pain and discomfort managed with medications.
• Temporary limitations on movement and daily activities.
• Physical therapy to regain strength and mobility.
• Gradual improvement in pain and functional ability over time.