{"title":"Acetabulum","description":null,"products":[{"product_id":"posterior-acetabular-fracture-surgery","title":"Fracture of the Posterior Acetabular Wall with Hip Dislocation","description":"\u003cp class=\"MsoNormal\"\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eMaster the treatment of posterior acetabular wall fractures associated with hip dislocation. This training offers a technical immersion in a carefully planned and executed surgical approach, aiming for fragment reduction, fixation to re-establish joint congruence, and hip stability.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cb\u003eTraining Focus:\u003c\/b\u003e\u003c\/p\u003e\n\u003cul style=\"margin-top: 0cm;\" type=\"disc\"\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eSurgical treatment of posterior acetabular wall fractures with hip dislocation.\u003c\/span\u003e\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"\u003eKocher-Langenbeck surgical approach.\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eReduction and fixation of fragments to restore joint anatomy and function.\u003c\/span\u003e\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eProtection of neurovascular structures, with emphasis on the sciatic nerve and circumflex artery.\u003c\/span\u003e\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eReconstruction of external rotator muscles.\u003c\/span\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cb\u003eDetailed Content:\u003c\/b\u003e\u003c\/p\u003e\n\u003cul style=\"margin-top: 0cm;\" type=\"disc\"\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l1 level1 lfo2; tab-stops: list 36.0pt;\"\u003e\n\u003cb\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eInitial Assessment and Optimized Surgical Access\u003c\/span\u003e\u003c\/b\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003e: Learn to interpret CT scans to identify hip dislocation and large posterior acetabular wall fragments. Master the Kocher-Langenbeck approach, using landmarks such as the apex of the greater trochanter, the posterior superior iliac spine, and the long axis of the femur.\u003c\/span\u003e\n\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l1 level1 lfo2; tab-stops: list 36.0pt;\"\u003e\n\u003cb\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eStrategic Dissection and Exposure\u003c\/span\u003e\u003c\/b\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003e: Develop the skill of performing an incision in the iliotibial tract and blunt dissection through the gluteus maximus fibers. Identify and elevate the gluteus medius, and perform tenotomy of the gluteus maximus to facilitate exposure. Identify the external rotators, including the piriformis, superior gemellus, obturator internus, and inferior gemellus.\u003c\/span\u003e\n\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l1 level1 lfo2; tab-stops: list 36.0pt;\"\u003e\n\u003cb\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eNeurovascular Protection and Safe Tenotomy\u003c\/span\u003e\u003c\/b\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003e: Execute piriformis tenotomy and identify the superior and inferior gemellus muscles, and the obturator internus. Understand the crucial protection of the quadratus femoris, due to the passage of the circumflex artery that nourishes the femoral head in this region. Use the retracted tendons (piriformis and gemelli) as padding for the sciatic nerve, which passes adjacent to the access.\u003c\/span\u003e\n\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l1 level1 lfo2; tab-stops: list 36.0pt;\"\u003e\n\u003cb\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003ePrecise Fragment Identification and Reduction\u003c\/span\u003e\u003c\/b\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003e: Learn how to identify the inferior and superior fragments of the acetabular roof. Learn to clean and free the joint for better identification of reduction parameters, and reposition the fragments in their anatomical locations after dislocation reduction.\u003c\/span\u003e\n\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l1 level1 lfo2; tab-stops: list 36.0pt;\"\u003e\n\u003cb\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eProvisional Fixation and Plate Contouring\u003c\/span\u003e\u003c\/b\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003e: Master the technique of introducing the inferior retractor into the lesser sciatic notch after careful detachment. Perform provisional fixation of fragments with Kirschner wires. Use aluminum to contour a plate model, which will be used for the definitive fixation plate.\u003c\/span\u003e\n\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l1 level1 lfo2; tab-stops: list 36.0pt;\"\u003e\n\u003cb\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eDefinitive Fixation with Multiple Plates\u003c\/span\u003e\u003c\/b\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003e: Learn to fix the main plate to the ischium, contouring the entire posterior rim, with screws directed towards the acetabular roof. Use a second plate at the apex of the superior fragment for fixation. Understand how the use of these two plates provides satisfactory reduction and stability, eliminating the need for spring plates.\u003c\/span\u003e\n\u003c\/li\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l1 level1 lfo2; tab-stops: list 36.0pt;\"\u003e\n\u003cb\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eAnatomical Reconstruction and Closure\u003c\/span\u003e\u003c\/b\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003e: Perform identification and reconstruction of the piriformis, superior gemellus, inferior gemellus, and obturator internus tendons. Learn to reinsert the piriformis in its original position, with slight external rotation of the hip assisting in tendon reinsertion. Restore the anatomical structure with preservation of the quadratus femoris and gluteus medius, without muscle cuts. \u003c\/span\u003eFinalize with suture of the iliotibial tract.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cb\u003eIncluded Material:\u003c\/b\u003e\u003c\/p\u003e\n\u003cul style=\"margin-top: 0cm;\" type=\"disc\"\u003e\n\u003cli class=\"MsoNormal\" style=\"mso-list: l0 level1 lfo3; tab-stops: list 36.0pt;\"\u003e\n\u003cb\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eDetailed Technical PDF\u003c\/span\u003e\u003c\/b\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003e: Didactic document describing the surgical procedure for treating posterior acetabular wall fractures associated with hip dislocation, from initial evaluation to reconstruction and closure.\u003c\/span\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cspan lang=\"EN-US\" style=\"mso-ansi-language: EN-US;\"\u003eEnhance your hip surgery skills. Enroll now and master advanced techniques for acetabular reconstruction, ensuring restoration of joint congruence and hip stability for your patients.\u003c\/span\u003e\u003c\/p\u003e","brand":"Dr Savio Chami","offers":[{"title":"Default Title","offer_id":42776980521021,"sku":null,"price":30.0,"currency_code":"BRL","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0641\/3664\/2621\/files\/Fracture-of-the-Posterior-Acetabular-Wall-with-Hip-Dislocation.webp?v=1764858229"},{"product_id":"acetabulum-case-02-posterior-rim-articular-impaction","title":"ACETABULUM [CASE 02] · Posterior Rim + Articular Impaction","description":"\u003cp\u003eThe presence of osteochondral impaction associated with a posterior wall acetabular fracture imposes a mandatory technical sequence: without prior disimpaction, anatomical reduction of the wall fragment cannot be completed. This training presents the complete management of a hip fracture-dislocation with a multifragmentary posterior wall fracture and associated impaction, using the Kocher-Langenbeck approach, protective repair of the external rotators, articular disimpaction guided by tomographic correlation, and fixation with spring plates and a contoured posterior column plate, demonstrated in 4K video from the surgical perspective.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eTRAINING FOCUS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003eCorrelation between three-dimensional tomographic reconstruction and fracture pattern.\u003c\/li\u003e\n\u003cli\u003eKocher-Langenbeck approach and anatomical landmarks in a patient with increased muscle mass.\u003c\/li\u003e\n\u003cli\u003eTenotomy and protective repair of the external rotators.\u003c\/li\u003e\n\u003cli\u003eRetractor anchoring in the greater and lesser sciatic notches.\u003c\/li\u003e\n\u003cli\u003eOsteochondral disimpaction and restoration of the articular surface.\u003c\/li\u003e\n\u003cli\u003eReduction sequence: impaction before posterior wall.\u003c\/li\u003e\n\u003cli\u003eProvisional fixation with Kirschner wires.\u003c\/li\u003e\n\u003cli\u003ePositioning and contouring of spring plates for multifragmentary fragments.\u003c\/li\u003e\n\u003cli\u003ePosterior column fixation with a plate contoured from the acetabular roof to the ischium.\u003c\/li\u003e\n\u003cli\u003eTransosseous reinsertion of the external rotators.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eDETAILED CONTENT\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eApplied Tomographic Reading:\u003c\/strong\u003e Direct correlation between the 3D reconstruction and intraoperative findings for identification of fragments, the posterior column fracture line, and the impaction area.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eKocher-Langenbeck Approach in a Difficult Field:\u003c\/strong\u003e Anatomical landmarks and adaptation of exposure in a young patient with increased muscle volume.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eVascular and Neural Protection:\u003c\/strong\u003e Preservation of the quadratus femoris and the circumflex artery, identification of the sciatic nerve course, and use of the repaired rotators as a protective barrier.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eSafe Retractor Anchoring:\u003c\/strong\u003e Positioning technique guided by digital palpation in the greater and lesser sciatic notches.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eOsteochondral Disimpaction:\u003c\/strong\u003e Elevation of the fragment with an adequate volume of cancellous bone for stable support without the need for grafting.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eImpaction-Wall Reduction Sequence:\u003c\/strong\u003e Two-stage reduction logic, with the femoral head functioning as a mold for the anatomical fit of the fragment.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eFixation with Spring Plates:\u003c\/strong\u003e Positioning criteria, staggered screw tightening, and directioning that avoids articular penetration.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eContouring and Fixation of the Posterior Column:\u003c\/strong\u003e Plate-bending technique during screw tightening and fixation from the acetabular roof to the ischium.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eRepair and Reinsertion of the External Rotators:\u003c\/strong\u003e Transosseous technique with holes in the greater trochanter for direct tendon-to-bone contact.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eINCLUDED MATERIAL\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDetailed PDF:\u003c\/strong\u003e The PDF presents the tomographic analysis of the acetabular fracture-dislocation with associated impaction, the complete sequence of the Kocher-Langenbeck approach, the neurovascular protection criteria during exposure, the technical logic of disimpaction prior to posterior wall reduction, the fixation principles using spring plates and a contoured posterior column plate, and the transosseous reinsertion protocol for the external rotators.\u003c\/p\u003e\n\u003cp\u003eMaster the reduction sequence in acetabular fractures with associated impaction. Enroll now and apply this technical logic in your next surgery.\u003c!-- notionvc: b1401372-791e-4221-b240-b5a01a972726 --\u003e\u003c\/p\u003e\n\u003cp\u003e\u003c!-- notionvc: 64e0f07a-3248-4325-8654-a80dfdfb7ead --\u003e\u003c\/p\u003e","brand":"Dr Savio Chami","offers":[{"title":"Default Title","offer_id":43320158617661,"sku":null,"price":30.0,"currency_code":"BRL","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0641\/3664\/2621\/files\/Acetabulo-Caso02-Rebordoposterior.webp?v=1783098829"}],"url":"https:\/\/www.surgie.com\/ar\/collections\/custom-sub_especialidade-acetabulum.oembed","provider":"Surgie","version":"1.0","type":"link"}