Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table for the procedure.

Anatomical surgical approach:  A lateral window approach was utilized to access the iliac wing. Reduction was achieved at the wing exit initially, followed by reduction at the SI exit using a Jungbluth clamp. After stabilizing the hemipelvis, further manipulation was required due to persistent instability of the SI joint, necessitating an open anterior clamp application.

The operative course was complex due to the multi-segmental nature of the pelvic ring injury. Initial percutaneous attempts were unsuccessful in achieving adequate reduction of the iliac wing fracture. The lateral window approach allowed for direct visualization and manipulation, facilitating successful reduction and stabilization. Despite achieving a stable hemipelvis, the SI joint remained unstable, requiring additional open clamping techniques to achieve satisfactory alignment.

Postoperative protocol:   Postoperative rehabilitation included non-weight bearing on the affected side for six weeks, followed by gradual weight-bearing as tolerated. Physical therapy focused on range of motion and strengthening exercises to support recovery.

Follow up:   Not specified.

Orthopaedic implants used:   External fixator, Schanz pin, LC2 screws, Jungbluth clamp.