Product Description

The Pelvic Fixator is an adjustable link system for rapid pelvic stabilisation.

The major threat from pelvic ring injuries is blood loss, the source being a variable combination of arterial bleeding, venous bleeding and bleeding from cancellous bone. As a general rule, an unstable pelvic ring is best stabilized as soon as possible and the benefit of external fixation is that it is minimally invasive and can be applied rapidly. Once stabilisation is achieved, the patient can then be moved and turned for further diagnostic measures if indicated. In comparison with internal fixation techniques, the benefit of rapid application outweighs the minimal inconvenience. It reduces the pelvic volume and produces an excellent tamponade effect. The possibility of persistent bleeding must be considered, and carefully monitored after application of the fixator.

For anterior open book type injuries, external fixation is intended as a definitive treatment and not as a temporary measure. For more extensive injuries causing anterior and posterior instability, external fixation provides excellent initial stabilisation and reduces the pelvic volume. After resuscitation and stabilisation, definitive posterior fixation can be carried out. The anterior fixation can also be definitive in this situation, with fixator removal at around eight weeks.

stabilisation with the Orthofix Pelvic Fixator is achieved by means of self-drilling screws inserted into the pelvis, and a fixator assembly which consists of two primary links joined by a connector unit. The simplicity of the system eases handling of the fixator and the ball-joints facilitate fracture reduction. Furthermore, the sliding link system allows the fixator to cover a wide range of pelvic sizes, thus significantly reducing the inventory.

The bone screws can be placed anteriorly in the hard bone above the acetabulum. This position is biomechanically very stable, and allows abdominal exploration without removing the fixator. Alternatively the screws can be placed independently in the iliac crest, care being taken to ensure that the screws are in good bone. The full technique is described in the operative technique and shown clearly in the video. The latter is included in the CD ROM containing the Applications by Anatomical Site and the Catalogue.

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Indications
  • Definitive stabilisation of anterior instability (open book injuries)
  • Emergency stabilisation of complete pelvic instability, allowing resuscitation and stabilisation before definitive fixation

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Surgeon Benefits
  • Assures pelvic stabilisation with a minimally invasive procedure
  • Permits rapid application
  • Provides definitive treatment
  • Reduces inventory as it covers a wide range of pelvic sizes

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Surgeon Support Materials
* Protected PDF files: You will not be able to copy or print.

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Clinical References
  • De Bastiani G, Aldegheri R, Renzi-Brivio L: The Treatment of Fractures with a Dynamic Axial Fixator. J. Bone Joint Surg., 1984; 66-B: 538-545.
  • Bell AL, Smith RA, Brown TD, Nepola JV: Comparative Study of the Orthofix and Pittsburgh Frames for External Fixation of Unstable Pelvic Ring Fractures. Journal of Orthopaedic Trauma 1988; 2 (2): 130-138.
  • Bucholz RW: The Pathological Anatomy of Malgaigne Fracture Dislocations of the Pelvis. J. Bone Joint Surg. 1981; 63-A: 400-404.
  • Haeske-Seeberg H: Inaugural Dissertation, Westfälische Wilhelms - Universität Münster 1988.
  • Hesp WL, Van Der Werken C, Keunen RW, Goris RJ: Unstable Fractures and Dislocations of the Pelvic Ring: Results of Treatment in Relation to the Severity of Injury. Netherlands Journal of Surgery 1985; 37: 148-152.
  • Malgaigne JF: Treatise in Fractures. Philadelphia; Lippincott 1859.
  • Martin JG, Nepola JV, Marsh JL: The Treatment of Unstable Pelvic Injuries with the Orthofix External Fixator. Supplement to International Journal of Orthopaedic Trauma 1993; 3(3): 49-51.
  • Mears DC, Fu FH: Modern Concepts of External Skeletal Fixation of the Pelvis. Clinical Orthopaedics 1980; 151: 65-72.
  • Müller-Färber J, Müller KH: Die Verschiedenen Formen der Instabilen Beckenringverletzungen und ihre Behandlung. Unfallheilkunde 1984; 87: 441-445.
  • Pauwels F: Gesammelte Abhandlung zur funktionellen Anatomie des Bewegungsapparates. Berlin; Springer-Verlag (1965).
  • Penning D, Klein W, Brug E: Pelvic ring disruption. In External Fixation and Functional Bracing, 191-195. Editors Coombs R, Green S, Sarmiento A. 1989. Orthotext, England.
  • Penning D: The Place of Anterior External Fixation in the Stabilization of Pelvic Ring Disruptions. Supplement to International Journal of Orthopaedic Trauma 1993; 3 (3): 44-48.
  • Penning D, Gladbach B, Majchrowski W: Pelvic Ring Disruption following Spontaneous Childbirth. J. Bone Joint Surg. (Br) 1997; 79B: 438-440.
  • Penning D, Gausepohl T: External Fixation in Pelvic Ring Injuries: the Pelvic Fixator. Orthofix External Fixation in Trauma and Orthopaedics. G. De Bastiani, A.G. Apley, A. Goldberg (Eds), Springer 2000; 219-235.
  • Rieger H, Penning D, Brug E, Bünte H, Krings W: Beckenringverletzung und Bauchtrauma. Unfallchirurg. 1991; 94: 110-115.
  • Schweiberer I, Dambe LT, Klapp F: Die Mehrfachverletzung: Schweregrad und therapeutische Richtlinien. Chirurg. 1978; 49: 608-614.
  • Slätis P, Huittinen VM: Double Vertical Fractures of the Pelvis. Acta Chirurgica Scandinavica 1972; 138: 799-807.
  • Tile M: Fractures of the Pelvis and Acetabulum. Baltimore; Williams and Wilkins 1984.
  • Tile M: Pelvic Ring Fractures: Should They be Fixed? J. Bone Joint Surg. 1988; 70-B: 1-12.

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Patient Benefits
  • Minimally invasive procedure
  • Rapid application
  • Definite treatment

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