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Orthopaedics
Sacral Fractures (AO Based)
Built from AO Surgery Reference: Spine Trauma, Degenerative, Tumors and Deformities (AO Foundation)
What’s inside
1 sections · 103 slides
Overview
- Introduction
- Sacral trauma: scope of this seminar
- Anatomy and biomechanics
- Radiographic anatomy of the upper sacrum
- Radiographic anatomy of the upper sacrum
- Course of the S1 nerve root tunnels
- Upper sacral dysmorphism
- Upper sacral dysmorphism
- Normal versus dysmorphic upper sacrum
- Normal versus dysmorphic upper sacrum
- Clinical and radiographic assessment
- Neurological evaluation of sacral injuries
- Neurological evaluation of sacral injuries
- Motor, sensory and reflex examination
- Motor, sensory and reflex examination
- CT evaluation and planning
- CT evaluation and planning
- C-arm views for iliosacral screws
- C-arm views for iliosacral screws
- When fluoroscopic ISS is unsafe
- When fluoroscopic ISS is unsafe
- Insufficiency fractures
- AO Spine sacral classification
- AO Spine sacral type tree
- AO Spine sacral type tree
- Injury types as drawn by AO
- Injury types as drawn by AO (cont.)
- Type A and B groups
- Type A and B groups
- Type B3 and C groups
- Type B3 and C groups
- Neurological grades
- Case-specific modifiers
- Case-specific modifiers
- Type A injuries
- A1 injuries: coccyx and avulsions
- A1 injuries: coccyx and avulsions
- A2 and closed A3 injuries without deficit
- Treatment options: A3 fractures
- Treatment options: A3 fractures
- Decision logic: A3 fractures
- Indirect and direct decompression
- Indirect and direct decompression
- Laminectomy of an intact sacral lamina
- Laminectomy of an intact sacral lamina
- ORIF of A3 fractures: sacral plating
- ORIF of A3 fractures: sacral plating
- Type B injuries
- Principles for type B fractures
- Treatment options: type B fractures
- Treatment options: type B fractures (cont.)
- ISS fixation versus spinopelvic fixation
- ISS fixation versus spinopelvic fixation
- Decision logic: type B fractures
- Nonoperative care of unstable ring injuries
- Nonoperative care of unstable ring injuries
- Monitoring during skeletal traction
- Monitoring during skeletal traction
- Type C injuries
- Treatment options: C0 U-fractures
- C1 to C3: lumbosacral dissociation
- C1 to C3: lumbosacral dissociation
- Goals of fixation in dissociation
- Goals of fixation in dissociation
- Operative techniques
- Prone versus supine positioning
- Prone versus supine positioning
- Anesthesia, antibiotics and fluoroscopy
- Anesthesia, antibiotics and fluoroscopy
- Posterior midline approach
- Posterior midline approach
- Posterior paramedian approach
- Posterior paramedian approach
- Principles of ISS fixation
- Principles of ISS fixation
- Screw choice and supplementary fixation
- Reduction before ISS fixation
- Reduction before ISS fixation
- Iliosacral screw insertion: steps
- Iliosacral screw insertion: steps
- Pitfalls in ISS insertion
- Pitfalls in ISS insertion
- Final check after ISS fixation
- Final check after ISS fixation
- Triangular osteosynthesis
- Spinopelvic fixation: sequence
- Spinopelvic fixation: sequence
- Iliac screw entry points
- Iliac screw entry points
- Restoring length in C3 injuries
- Restoring length in C3 injuries
- Reduction of C3 dislocations
- Reduction of C3 dislocations
- Aftercare and complications
- Early postoperative care
- Weight bearing after fixation
- Complications named by AO
- Take-home messages
- References (1 of 4)
- References (2 of 4)
- References (3 of 4)
- References (4 of 4)
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