Based upon the results obtained in two actual cases and in three experiments on the cadaver, it is possible to obtain reduction of fracture of the pubes (ascending and descending rami), separation of the symphysis pubis, and central fracture of the acetabulum.
After being properly padded, each limb, from groin to toes, is immobilized in plaster in which are incorporated the receptors for two turnbuckles.
In the treatment of the pubic fracture, the limbs are moderately abducted and the open turnbuckle is placed distally, while the closed turnbuckle is placed proximally.
In treating the central fracture of the acetabulum, the limbs are widely abducted and the turnbuckles are placed in the same way as for the pubic fracture.
For the separation of the symphysis pubis, the limbs are slightly abducted and the open turnbuckle is placed proximally, while the closed turnbuckle is placed distally.
Much of the force of the leverage was lost, as the limbs tended to go into a position of external rotation. To combat this, two turnbuckles are now placed proximally,-one anteriorly and one posteriorly, the posterior turnbuckle being used as a derotator.
The author is greatly indebted to Dr. Walter I. Galland who treated the case reported.
(C) 1935 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.