SIAI dislocation treatment
Fracture of the Spina Iliaca Inferior in young patients. Generally this occurs with hyperextension trauma and contracted rectus muscle.
The patient has painful active hip flexion. Diagnosis is done by Rx, RMN or echographic images.
Surgery: short anterior approach to the hip (here: left hip, signed the SIAS, trochanter; the incision line is above the septum intermuscolaris. The straigth line is the incision line). The incision is distal and lateral to the spina iliaca anterior superior, about 5-6 cm length. Incision of the fascia latae above the tensor muscle. Then between tensor and sartorius you reach the anterior region of the acetabulum, where you can feel the dislocated fragment
Fixation: K-wire temporary and definitive cannulated screw (4.5) - in this case 50 mm length with large pusher
X-ray control: left hip. Left image: ap projection image above: faux profile. You see the anterior acetabular border and the fixating screw Post OP: no weigth bearing and no active hip flexion for about 3-4 weeks. Then reduced weigth contact for further 2-3 weeks.