Adam Starr, M.D. Answers Questions On: Pelvic fractures

Mostly we treat high-energy trauma patients. We see people who’ve been involved in auto accidents, construction workers who fall off scaffolding, or people who get hit by a car – injuries such as that. We also treat some people who slip and fall and break a hip.

The standard or traditional technique involves open incisions around the pelvis, which have fairly high complication rates, such as infection, wound dehiscence (wound splitting open), and then scarring. But the percutaneous techniques involve zero infection – they never get infected. The scar tissue’s minimized, postoperative pain is minimized, and the recovery is quicker.

When I was a resident in training and people had their gallbladder out, they had it taken out through a big incision under their rib cage. Now, nobody has that done; they do it through a scope. It’s like that with percutaneous surgery – you get the same result, the same realignment of the bones, but it's done through a much smaller surgical approach. It’s a lot better for the patient.

Most pelvic fractures are not very displaced; they’re very minor and they tend to heal well without surgery. But some of them get displaced a lot – the pieces of bone are just sort of exploded – and if you don't want to do a big, open operation then it's hard to realign the pieces. So we developed this frame that allows us to realign the pieces of bone with tiny little poke-hole incisions. Once you do that, once you’ve got them realigned, then you can stabilize the bone. You put screws across the fractures through little stab incisions. The patients do great – they never get infected, they heal quicker, you don’t do any stripping of the muscle, and rehab is easier. It’s been a big advance.