Download TOTAL DISLOCATION OF THE ILIUM Report of a Case

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