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Anterior Wall Fractures

- Discussion:
    - anterior wall frx involve central portion of anterior column & involves iliopectineal line is involved;
    - associated injury: anterior hip dislocation;

- Technique of Fixation:
    - anterior wall fractures are approached thru Ilioinguinal Approach w/ supine positioning;
    - traction removes femoral head from the centrally displaced position;
    - Reduction is achieved;
    - fixation is with a curved plate placed along the pelvic brim from the superior ramus to the internal iliac fossa;
    - because screws are placed along brim, acetabulum can be easily entered;
         - screws should be placed close to pelvic brim in direction parallel to the quadrilateral surface;
         - in area of pectineal eminence only short screw (approx 12-14 mm long) is placed to avoid entering the joint;

- Anterior Wall Fracture: Implants:
    - 6.5 mm cancellous bone screws as lag screws;
    - 7.0 mm cannulated screws as lag screws;
    - 4.0 mm cancellous bone screws;
    - 3.5 mm reconstructed plate, curved

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