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Antegrade Ramus

Antegrade Ramus. MLC Routt Jr MD Harborview Medical Center Seattle WA USA. Position. Supine Prone. Ramus Imaging. C-Arm Non-Injured Side Inlet Tilt Obturator Oblique-Outlet Tilt. Inlet. Anterior Wall Psoas Gutter AIIS Iliopectineal Eminence Posterior Border Parasymphyseal

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Antegrade Ramus

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  1. Antegrade Ramus MLC Routt Jr MD Harborview Medical Center Seattle WA USA

  2. Position • Supine • Prone

  3. Ramus Imaging • C-Arm Non-Injured Side • Inlet Tilt • Obturator Oblique-Outlet Tilt

  4. Inlet • Anterior Wall • Psoas Gutter • AIIS • Iliopectineal Eminence • Posterior Border • Parasymphyseal • Symphysis

  5. Obturator Oblique - Outlet • Cranial Border • Acetabular Dome • Obturator Sulcus • Parasymphyseal

  6. Reduction • Open • Closed • Manipulative • Screw • Other

  7. Initial Wire • Thin Diameter K-Wire • Positioned Perfectly • Starting Point • Aim • Inserted 3-5mms

  8. Cannulated Drill • Fits Over Wire • Allows Minor Redirections/Aim Adjustments • To Fracture Site • Slightly Beyond Fracture in Some

  9. Calibrated Small Drill • Thru Protective Sleeve of Known Length • Beyond Fracture • Symphyseal Endpoint • Depth from Sleeve-Calibrated Drill

  10. Screw Insertion • Size • Length • Secure • Assess Stability-Fluoroscopy • Supplement as Necessary

  11. Numerous Options • Cannulated System • Reduction Maneuvers • Fixation Details • Supplementation • Others

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