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Pelvic external fixator
2%
25/1452
Open reduction and reconstruction plating of the symphysis
14%
209/1452
Protected weightbearing and binder as needed and observation
81%
1180/1452
Open reduction and wiring of the symphysis
1%
19/1452
Symphysiotomy
0%
7/1452
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The clinical presentation and radiograph is consistent with an open-book type parturition-induced pelvic dislocation. The case series by Kharrazi et al reports four patients treated with open-book type parturition-induced pelvic dislocations. The authors advocate nonoperative treatment with bedrest and a properly positioned pelvic binder in the acute setting for patients with a postpartum symphyseal diastasis less than 4.0 cm. All four patients had significant symptoms and radiographic widening (anterior splaying) of the sacroiliac joints. The three patients who had presented acutely were treated with closed reduction and application of a pelvic binder, while two had closed reduction of their pelvic dislocation while anesthetized with a general anesthetic. At latest follow-up the diastasis at the pubic symphysis reduced to an average of 1.7 cm (range: 1.5-2.0) The authors advocate nonoperative treatment with bedrest and a properly positioned pelvic binder in the acute setting for patients with a symphyseal diastasis of 4.0 cm of less and operative treatment for diastasis greater than 4cm.
4.2
(26)
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