title: Sequential reduction and fixation for windswept pelvic ring injuries (LC3) corrects the deformity until healed.
abstract: OBJECTIVE
  The restoration, and fixation, of normal pelvic anatomy after a windswept type injury can be a difficult endeavor and our purpose is to describe a method to accomplish this.
  
  
  METHODS
  A stepwise and sequential technique was utilized to effectively reduce and stabilize this injury pattern. By first closing down the open disruption posteriorly and fixing with a partially threaded SI screw, a stable platform was created upon which to work from and subsequently distract and reduce the contralateral side via an anterior internal fixator (seven), external fixator (one), or plate (one). This was followed by a fully threaded SI screw in the compression side of the sacral fracture to hold the distraction. Nine consecutive patients with LC3 (61-B3.2) were included in the study with an average FU of 15 months.
  
  
  RESULTS
  The Keshishyan deformity index revealed an initial mean deformity of 0.0456 which was corrected to 0.0170 (postop) and 0.0181 at latest follow up. This entailed an average correction of 62 % at the latest follow up. The follow-up group was significantly different from pre-op (p = 0.0040), but not post-op (p = 0.6833). Furthermore, post-op was significantly different from pre-op (p = 0.0089).
  
  
  CONCLUSIONS
  This is an effective method of correcting and maintaining reduction until healing for this relatively rare and difficult-to-treat injury pattern.
authors.affiliation: Orthopaedic Surgery, 4D4 University Health Center, Detroit Receiving Hospital, Wayne State University, 4201 St. Antoine Blvd., Detroit , Michigan 48201, USA. rahvaidya2012@gmail.com
authors.forename: Rahul
authors.initials: R
authors.lastname: Vaidya
authors.forename: Bryant W
authors.initials: BW
authors.lastname: Oliphant
authors.forename: Ian
authors.initials: I
authors.lastname: Hudson
authors.forename: Mitch
authors.initials: M
authors.lastname: Herrema
authors.forename: David
authors.initials: D
authors.lastname: Knesek
authors.forename: Fred
authors.initials: F
authors.lastname: Tonnos
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult