{"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\/products\/acetabulum-case-02-posterior-rim-articular-impaction","provider":"Surgie","version":"1.0","type":"link"}