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Anterior Pelvic Reduction and Fixation Using a Subcutaneous Internal Fixator

Gardner, Michael J. MD*; Mehta, Samir MD; Mirza, Amer MD; Ricci, William M. MD*

Journal of Orthopaedic Trauma: May 2012 - Volume 26 - Issue 5 - p 314–321
doi: 10.1097/BOT.0b013e318220bb22
Technical Trick

Summary: Acute traumatic pelvic instability mandates reduction and mechanical stabilization to maximize the chance of a good functional outcome. Posterior pelvic fixation is frequently inadequate to stabilize the pelvic ring in isolation. Fixation augmentation with anterior pelvic ring implants can take several forms, including plates, medullary screws, or external fixation. Based on a multitude of patient and injury factors, external fixation may be the definitive anterior pelvic implant of choice. However, many drawbacks exist with this treatment, most notably the high infection rates of the transcutaneous pins, impaired patient mobilization, and suboptimal mechanical properties. We present a technique of a subcutaneous anterior pelvic fixator as an alternative method of anterior pelvic ring reduction and stabilization that avoids many of the drawbacks of traditional anterior pelvic external fixation.

*Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO

Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA

Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

No funds were received in support of this work.

Reprints: Michael J. Gardner, MD, Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 South Euclid Avenue, St Louis, MO 63110 (e-mail:

Accepted April 20, 2011

© 2012 Lippincott Williams & Wilkins, Inc.