Transcondylar traction as a closed reduction technique in vertically unstable pelvic ring disruption

Area of Science:

• Orthopedic Surgery
• Trauma Management

Background:

• Pelvic ring disruptions, particularly vertically unstable fracture-dislocations of the sacroiliac joint, present complex challenges in orthopedic trauma.
• Limited literature exists on efficient closed reduction techniques for these injuries.

Purpose of the Study:

• To evaluate the efficacy of transcondylar traction as a closed reduction technique for vertically unstable pelvic ring disruptions.
• To assess the outcomes and complications associated with this method.

Main Methods:

• Twenty-four patients with pelvic ring disruptions underwent attempted closed reduction using transcondylar traction, followed by percutaneous screw fixation.
• Reduction success, residual displacement, and complications were meticulously documented.

Main Results:

• Successful closed reduction to within 1 cm of residual displacement was achieved in all cases.
• No infections or digestive, cutaneous, or vascular complications were reported.
• Secondary displacement occurred in three patients, with better correction achieved when reduction was performed within 8 days post-trauma.

Conclusions:

• Transcondylar traction is a viable closed reduction technique for vertically unstable pelvic ring disruptions.
• Early reduction (within 8 days) is crucial for optimal outcomes.
• Open approaches are recommended for specific complex fractures (crescent iliac, transforaminal with neurological deficit), and surgeons should be cautious with vertical sacral fractures due to fixation risks.