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TOTAL DISLOCATION OF Report W. B. MACKINNON From A girl aged Children’s for a fall years was with rock : she and in a state and The fell child down FIG. Radiograph upon 80 red her. Shock millimetres blood of the cell left was of the was present. distension pelvis, was of cartilage not dislocated, Treatment and transfusion intra-abdominal not 720 possible and There fracture-dislocation tn-radiate by the and and was left rotated Shenton’s litre injury at this stage no and intact. catheterisation, of matched was to found. manipulate blood, A the Arturo (W. coffee struck per by minute, revealed was the Grullion B. McK.) was beans when there loose and rock which extending fell The (Figs. was back no performed retroperitoneal (Dr THE Juan was region showed through femoral sacrum in the Abdominal The blood haematoma into 2). of the showed in the separated 1 and of and Radiographs was promontory pressure cent laterally. deficit. ilium laterally a blood 50 per swelling was marked felt entire which ilium the us Haemoglobin operation large was of neurological joint: was picking 130 examination posteriorly arc of prominence evidence been to of reduction. pulse sacro-iliac one and diastolic. a bony p;ogress-After of one pallor, and count half indicated shock I before 50 millimetres 2,710,000. Physical systolic of CANADA of !vlaizitoba where had a hill, MANITOBA, U,,iversiti’ Republic, Medico. slipped WINNIPEG, Departments, admitted Dominican Care ILIUM of a Case L. LANSDOWN, Radiology Santiago, work of E. Orthopedic thirteen Hospital, seconded was tili? and THE was the the head fractured. urine, Gonzoles). drained. and No It was position. JOURNAL OF BONE AND JOINT SURGERY TOTAL 1)ISLOCAT1ON OF TIlE 721 ILIUM ritj FIG. Drawing to show the Radiograph VOL. 54 B, NO. 4, NOVEMBER 1972 main features through after open of the tn-radiate reduction 2 injury. Inset cartilage. and internal shows line fixation. of separation 722 w. Four days Incision medial from to the made the view the tn-radiate joint. aspect were full along the posterior lateral attachments The reduction ilium across further the operation ilium, spine. The from ilium, and the iliopsoas from the anterior of the so that possible sacro-iliac the ilium to rotate the maintained by two anterior muscles muscle superior joint. hinged to reduce the gluteal freed cartilage, was of E. L. LANSDOWN of the also then AND permitted crest superior of the dislocation It was MACKINNON her condition later was B. The on the ilium anteriorly screws driven from and its pelvic surface. had ligaments the to into a point subperiosteally Muscular dissection disruption distally displacement. spine reflected This remaining from its permitted occurred a through of the sacro-iliac normal position. postero-lateral surface of the sacro-iliac joint to engage the sacrum plaster spica was applied to protect the rather tenuous the patient’s premature removal from hospital. Pressure for skin grafting was required. A year after the injury (Fig. 3). Thereafter a short double reduction. Progress was marred by sores developed and later readmission the girl was free from disability. Comment-It only have ossification of the the were spine. iliac the iliac superior is probable of the ilium by the tn-radiate impact that this injury could occur cartilage. The force must of rock while the pelvis lay in the in the immature skeleton, before been applied to the anterior part supine position. SUMMARY A case of total dislocation of the in a girl of thirteen years is described. We wish this case, to thank and ilium after No previous Care Medico and Dr Elio Melle Dr W. J. Hart of Winnipeg for help disruption description through the tn-radiate cartilage of this injury has been found. of the Dominican Republic with the illustrations. THE JOURNAL for the opportunity OF BONE AND of studying JOINT SURGERY