Man, 46 years old. He is a biker.
He received a horizontally unstable pelvic ring fracture:
• Posterior injury
The B1.1 posterior ring injury is a disruption of the anterior part of the right sacroiliac joint with anterior widening of the pelvis. Its posterior S-I ligaments remain intact
• Anterior injury
The typical anterior arch injury produced by B1 injuries is disruption of the pubic symphysis and fractures of the left pubis ramii (Nakatani II). Fractures are vertically oriented. (As well there is an occult stable fracture of the right pubic rami Nakatani III)
In addition: close fracture of the distal right femur with displacement.
On admittance: the supraacetabular Ex-Fix was applied to pelvis & right leg. Bladder was intact.
In the 22th day after the injury, we performed a combination of osteosynthesis with a plate and a locking nail (PuLock) via the same Pfannestiel approach. It's noteworthy that the nail was locked through a plate hole. The right S-I joint fixation with lag screw was performed on S1 level.
• Intra/op blood loss – 200 ml
• Duration of the operation - 120 min