Trans-ilial and transsacral brace fixation of sacral fractures and sacro-iliac luxations (seven cases)

Summary

Trans-ilial brace fixation was used as the primary repair of two sacral fractures and in conjunction with a trans-sacral pin for the repair of a bilateral sacro-iliac luxation and a sacral fracture with contralateral sacroiliac luxation. Trans-ilial brace fixation was also used as a secondary fixation for two unilateral sacro-iliac luxations and a bilateral sacro-iliac luxation. Follow-up radiographic parameters were compared to post-operative radiographic parameters to assess the stability of the fixation and the progression of healing. There was not any morbidity associated with the trans-ilial brace technique and all of the cases healed uneventfully. Indications for the use of the trans-ilial brace include sacro-iliac injuries where an additional means of stability may be indicated, comminuted sacral fractures in which the landmarks for lag screw fixation are obscured and bilateral sacro-iliac injuries with the concurrent use of a trans-sacral pin.

Keywords

Trans-ilial brace - sacral fracture - sacro-iliac luxation

^* Presented at the 30^th Annual Conference, Veterinary Orthopaedic Society, February 23 to 28, 2003, Steamboat Springs, Colorado.

• References

• 1 Averill SM, Johnson AL, Schaeffer DJ. Risk factors associated with development of pelvic canal stenosis secondary to sacro-iliac separation: 84 cases (1985-1995). J Am Vet Med Assoc 1997; 211: 75-8.
• 2 Betts CW. Pelvic fractures. In: Textbook of small animal surgery. Slatter D. ed. Philadelphia: WB Saunders; 1993: 1769-86.
• 3 DeCamp CE, Braden TD. Sacro-iliac fractureseparation in the dog. A study of 92 cases. Vet Surg 1985; 14: 127-30.
• 4 DeCamp CE, Braden TD. The surgical anatomy of the canine sacrum for lag screw fixation of the sacro-iliac joint. Vet Surg 1985; 14: 131-4.
• 5 Hulse DA, Shires P, Waldron D, Hedlund C. Sacro-iliac luxations. Comp Contin Ed Pract Vet 1985; 07: 493-500.
• 6 Jacobson A, Schrader SC. Peripheral nerve injury associated with fracture or fracturedislocation of the pelvis in dogs and cats: 34 cases (1978-1982). J Am Vet Med Assoc 1987; 190: 569-72.
• 7 Kolata RJ, Johnston DE. Motor vehicle accidents in urban dogs: a study of 600 cases. J Am Vet Med Assoc 1975; 167: 938-41.
• 8 Kuntz CA, Waldron D, Martin RA, Shires PK, Moon M, Shell L. Sacral fractures in dogs: a review of 32 cases. J Am Anim Hosp Assoc 1995; 31: 142-50.
• 9 Lewis DD, Stampley A, Bellah JR, Donner GS, Ellison GW. Repair of sixth lumbar vertebral fracture-luxations, using trans-ilial pins and plastic spinous-process plates in six dogs. J Am Vet Med Assoc 1989; 194: 538-42.
• 10 Pare B, Gendreau CL, Robbins MA. Open reduction of sacral fractures using transarticular implants at the articular facets of L7-S1: 8 consecutive canine patients (1995-1999). Vet Surg 2001; 30: 476-81.
• 11 Philips L, Blackmore J. Kirschner-Ehmer device alone to stabilize caudal lumbar fractures in small dogs. Vet Comp Orthop Traumatol 1991; 04: 112-5.
• 12 Shores A, Nichols C, Koelling HA, Fox WR. Combined Kirschner-Ehmer apparatus and dorsal spinal plate fixation of caudal lumbar fractures in dogs: biomechanical properties. Am J Vet Res 1988; 49: 1979-82.
• 13 Shores A, Nichols C, Rochat M, Fox SM, Burt GJ, Fox WR. Combined Kirschner-Ehmer device and dorsal spinal plate fixation technique for caudal lumbar vertebral fractures in dogs. J Am Vet Med Assoc 1989; 195: 335-9.
• 14 Slocum B, Rudy RL. Fractures of the seventh lumbar vertebrae in the dog. J Am Anim Hosp Assoc 1975; 11: 167-74.
• 15 Tomlinson JL, Cook JL, Payne JT, Anderson CC, Johnson JC. Closed reduction and lag screw fixation of sacro-iliac luxations and fractures. Vet Surg 1999; 28: 188-93.
• 16 Ullman SL, Boudrieau RJ. Internal skeletal fixation using a Kirschner apparatus for stabilization of fracture/luxations of the lumbosacral joint in six dogs. A modification of the transilial pin technique. Vet Surg 1993; 22: 11-7.