Q&A with Dr. Charles Reinert
Would you explain your technique for repairing a broken pelvis with the Starr Frame?
Normally, one side of the pelvis is broken and the other side is not broken as badly. You attach the less injured or the non-injured side of the pelvis to the Starr Frame with some pins that are clamped to the frame, then you put pins in the other side wherever you want to in whatever vector (direction) you want to pull on. Using threaded rods with clamps, you can grab a pin that you’ve inserted in the bone and either push on it or pull on it, or you can shift it sideways to a certain extent.
Basically, you just push or pull on the fracture fragments till you've got them in place. Then once you’ve got them fixed, then you can just run some guidewires down the columns of bone where it’s safe, and that are appropriate for the fracture, and then run some screws over the guidewires and you're done. And mostly just through tiny incisions, small stab wounds, basically. When you’re done with it you just take the frame off, take the pins out and you’re done.
Fixing a broken pelvis with percutaneous techniques and the Starr Frame carries a lot of advantages over traditional methods, including faster recovery times and almost no infections. What other benefits does your procedure bring to patients?
When you do a traditional type of operation on an acetabular fracture, it’s not without complications. A few of them get infected, a few of them don't heal, a lot of them get arthritis. If you’re going to do a total joint replacement on them you have to take the hardware out – otherwise the total joint that you’re going to do becomes more difficult or even impossible because of hardware in the way.
We decided we would figure out how to minimize the amount of hardware we put in. If somebody develops arthritis in their hip after we’ve fixed the acetabulum percutaneously, it’s not a tremendous issue for surgeons to just do a normal total joint replacement. A few of them still wind up with arthritis and still need a joint replacement, but by and large it’s just a normal joint. Surgeons are operating through normal tissue. They’re not operating through a scar ball. So, the procedure is just pretty routine.