Fijación externa supra-acetabular de pelvis: nota técnica / Supra acetabular pelvic external fixation: technical note

RESUMEN

Introduction: External fixation is a useful technique for the treatment of instable pelvic fractures. There are several configuration alternatives regarding to Schanz pin placement. In order to assure safe placement of the Shanz pins, it is useful to obtain an intraoperative fluoroscopic image of the supra-acetabular teardrop, wich indicates the linear osseous path between the anterior inferior iliac spine (AIIS) and the posterior superior iliac spine (PSIS). Material and Method: The surgical technique for safe supra-acetabular pin placement is described using an anatomic piece corresponding to the pelvis of a middle-aged male. A combination of outlet and obturador projections is sued to show an adequate fluoroscopic vision of the supra-acetabular teardrop. The result of this technique is demonstrated with a case report. Results: Having achieved a proper intraoperative vision of the supra-acetabular teardrop, the Schanz pins can be safely placed from the anterior inferior iliac spine (AIIS) through the osseous corridor in order to reach the posterior superior iliac spine (PSIS). Conclusions: Placing both Schanz pins in the supra-acetabular area and guided under fluoroscopic vision as described in this technique, allows reaching the posterior pelvis, achieving better control of bone fragments and compression of the posterior pelvic ring through an anterior approach. Therefore, this technique is an excellent alternative for external fixation of an unstable pelvic fracture.