Surgical Discussion

Patient positioning:  The patient was positioned supine on a radiolucent table to facilitate intraoperative fluoroscopic imaging of the pelvis in multiple planes.

Anatomical surgical approach:  A percutaneous approach was utilized. After standard preparation and draping, a small incision was made over the entry point of the right superior pubic ramus. The near cortex was prepared in routine fashion. A curved guide was introduced along the intramedullary pathway of the superior pubic ramus, followed by measurement of required device length. Sequential reaming was performed: first with an opening reamer, then with a pathway reamer to accommodate the device trajectory. The insertion guide wire was exchanged into position, and the CurvaFix device was inserted along the prepared pathway. The device was then locked to achieve rigid fixation.

The application of the CurvaFix device was straightforward. Preparation of the near pathway, insertion of the curved guide, length measurement, reaming, and device insertion proceeded without technical difficulty. The device demonstrated rigid fixation upon locking, even in the presence of comminution at the fracture site.

Postoperative protocol:   Postoperatively, the patient was maintained toe-touch weight bearing on the affected side for 6 weeks, with progressive advancement to full weight bearing as tolerated thereafter. Early mobilization with physiotherapy was initiated to preserve hip and knee range of motion.

Follow up:   Not specified

Orthopaedic implants used:   CurvaFix 130mm length / 7.5mm diameter intramedullary device