Pelvic & Acetabular Fracture Management

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1 Final Program Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Chicago Marriott O Hare Chicago, Illinois Directly Provided by

2 AOCMF AOSpine AOTrauma AOVET EDUCATION FELLOWSHIPS MEMBERSHIP RESEARCH AO North America 1700 Russell Road Paoli, PA

3 A letter from the Chair of AOTrauma North America As Chair of the AOTrauma North America Education Committee, it is my pleasure to introduce you to this unique and exciting organization and our mission. Since 1958, the AO has been the worldwide leader in musculoskeletal trauma education. AONA provides comprehensive multidisciplinary education to surgeons, fellows and residents in orthopedic, craniomaxillofacial, spine and veterinary surgery. The AO ( Arbeitsgemeinschaft fur Osteosynthesefragen ) is a noncommercial entity dedicated to education, research and the advancement of surgical care. We are a fellowship of like-minded surgeons that span the globe. AONA was established as a regional entity of the AO Foundation in 1992 and continues the long tradition of teaching excellence. As an independent, surgeon-driven, nonprofit specialty society, AONA is dedicated to the advancement of patient care. Our mission is to improve the care of patients with musculoskeletal injuries in North America through education and research. Table of Contents CME Mission 4 Statement Course Description 5 Target Audience 6 Learner Objectives 6 Accreditation 6 Designation 6 Statement Faculty 7 9 Final Program Location Key 16 Presentation 17 Information Future Courses 18 I invite you to participate in the many opportunities offered by AOTrauma North America. There is a wide spectrum of educational activities to meet the life-long learning needs of surgeons. Whether as a resident, fellow or attending surgeon, AOTNA offers modern teaching techniques and state-of-the-art courses that are tailored for today s learner. Our educational activities include annual courses, symposia, regional summits and workshops throughout the world. AO North America has developed a systematic approach to education and course offerings. Beginning at the basic principles level and continuing through to the complex care of a variety of musculoskeletal disorders we cover it all. Specialty courses are intensive and focus on specific anatomical areas of the musculoskeletal system. Each educational offering has its own unique structure, at times employing didactic sessions, hands-on laboratory, cadaveric specimens, small group discussions, expert panels and live surgery. AO North America is recognized globally for providing excellent surgical education. Participating in these activities will be extremely valuable to you as you strive to improve patient care throughout your career. Sincerely, Roger Wilber

4 4 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) CME Mission Statement The Continuing Medical Education (CME) mission of AO North America (AONA ) is to provide comprehensive multidisciplinary needs-based education to surgeons, fellows, and residents in the specialties of orthopedic, hand, craniomaxillofacial, spine, neurosurgery, and veterinary surgery in the areas of trauma (i.e., operative reduction and fixation), degenerative disorders, deformities, tumors, and reconstruction. Expected results of AONA s CME activities for surgeons, fellows, and residents are to: Increase their knowledge base and surgical skill level Improve competence by applying advances of knowledge in patient care in the areas of trauma, degenerative disorders, deformities, tumors, and reconstructive surgical techniques Address practice performance gaps by improving management of all aspects of musculoskeletal injuries and disorders (i.e., pre-operative planning to post-operative care)

5 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) 5 Course Description Although pelvic and acetabular fractures are relatively uncommon injuries, they are often complex, difficult to understand and associated with life threatening trauma. The incidence of complications may be quite high and surgeons are often unfamiliar with the regional anatomy of the pelvis and the specialized reduction techniques and implants necessary to treat these injuries. The initial management of a patient with an unstable pelvic fracture may be life-saving or significantly decrease ultimate morbidity. Practicing orthopaedic surgeons are often faced with the initial management of these patients while taking emergency room call but are unprepared during their residency training to provide this management. Even practicing trauma surgeons who have graduated from a trauma fellowship often seek advice and additional instruction in managing these complex injuries. The management of pelvic and acetabular fractures is inherently difficult. Surgical approaches are complex and involve unfamiliar anatomy often poorly understood by orthopaedic surgeons. The radiographic anatomy of the pelvis is complex and difficult to understand. Reduction and fixation techniques are challenging and require specialized instruments and implants as well as knowledge of reduction techniques and maneuvers. This course will address the radiographic understanding of complex pelvic and acetabular fracture patterns, improve the surgeons understanding and ability to classify fractures of the pelvis as well as allow them the opportunity to practice surgical approach, reduction and fixation techniques. Target Audience Enrollment in this course is open to orthopedic surgeons with pelvic and acetabular surgery in their current or planned practice. This course is not designed for junior residents.

6 6 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Learner Objectives At the conclusion of this Course, the participant should be able to: Define key elements in the initial evaluation and management of patients with pelvic and acetabular fractures Assess pelvic and acetabular fractures as a component of a complex polytrauma situation Classify pelvic and acetabular fractures based upon an understanding of the radiographic appearance of the normal and injured pelvis Determine and demonstrate the appropriate surgical approach for pelvic and acetabular fractures Demonstrate appropriate decision-making strategies and define indications for operative management Perform techniques of reduction and internal/external fixation as applicable to pelvic and acetabular fracture patterns Recognize ongoing controversies in the care of injured patients with multiple pelvic and acetabular fractures Accreditation AO North America is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. AONA has been resurveyed by the Accreditation Council for Continuing Medical Education (ACCME) and awarded Accreditation with Commendation. Designation Statement AO North America designates this live educational activity for a maximum of AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. For Canadian Based Physicians Attending AONA Courses All live conferences or live courses held outside of Canada can be reported as accredited group learning activities under Section 1 of the MOC Program if they are developed by a university, academy, college, academic institution or physician organization. Courses sponsored by AO North America meet the criteria of the Royal College of Physicians and Surgeons for accredited group learning activities.

7 Faculty Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) 7 The faculty of this Course is composed of international surgeons distinguished in the field of operative fracture care. Course Chairpersons Keith Mayo, MD Director, Hansjörg Wyss Hip and Pelvis Center Swedish Medical Center Seattle, Washington H. Claude Sagi, MD Professor Harborview Medical Center Department of Orthopedics and Sports Medicine University of Washington Seattle, Washington Course Director Tania A. Ferguson, MD Nashville Sports Medicine & Orthopaedic Center Nashville, Tennessee Course Evaluator Roger G. Wilber, MD Metrohealth Medical Center Cleveland, Ohio

8 8 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Faculty (continued) Michael J. Bellino, MD Clinical Associate Professor Stanford University Medical Center Dept of Orthopaedic Surgery Stanford, California Cory Collinge, MD Professor Department of Orthopedic Surgery Vanderbilt University Nashville, Tennessee Brett D. Crist, MD Associate Professor Director Orthopaedic Trauma Service Director Orthopaedic Trauma Fellowship Department of Orthopaedic Surgery Columbia, Missouri Pierre Guy, MD, MBA Associate Professor University of British Columbia Vancouver, British Columbia Eric E. Johnson, MD, FRCSI Walter and Kathryn Mullikin Professor of Orthopaedic Trauma Chief, Orthopaedic Trauma David Geffen School of Medicine Department of Orthopaedic Surgery University of California Los Angeles Los Angeles, California Conor Kleweno, MD Assistant Professor Orthopaedics and Sports Medicine University of Washington Harborview Medical Center Seattle, Washington Hans J. Kreder, MD, MPH, FRCS(C) Professor, Orthopaedic Surgery & Health Policy Evaluation & Management, University of Toronto Trauma and Adult Reconstructive Surgery Sunnybrook Health Sciences Centre Toronto, Ontario Philip J. Kregor, MD Director of Orthopedic Trauma The Hughston Clinic TriStar Skyline Medical Center Nashville, Tennessee James Learned, MD Assistant Professor Orthopaedic Trauma UC Irvine Medical Center Orange, California Michael P. Leslie, DO Associate Professor, Orthopaedic Surgery Associate Chief of Orthopaedic Trauma Yale School of Medicine New Haven, Connecticut Jason W. Nascone, MD Associate Professor Department of Orthopaedics R. Adams Cowley Shock Trauma Center University of Maryland Baltimore, Maryland Steven A. Olson, MD, FACS Professor, Department of Orthopaedic Surgery Hip Preservation Surgery Pelvis and Hip Reconstruction Duke University Medical Center Durham, North Carolina

9 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) 9 Faculty (continued) Mark C. Reilly, MD Professor of Orthopaedic Surgery Chief, Orthopaedic Trauma Service Department of Orthopaedics Rutgers New Jersey Medical School Newark, New Jersey Jason W. Roberts, MD Medical Director of Orthopaedic Trauma Bronson Methodist Hospital Clinical Assistant Professor Department of Orthopaedic Surgery Western Michigan University School of Medicine Kalamazoo, Michigan David Rothberg, MD Assistant Professor University of Utah Department of Orthopaedics Salt Lake City, Utah Stephen H. Sims, MD Professor-Orthopaedic Trauma Department of Orthopaedic Surgery Carolinas Medical Center Charlotte, North Carolina David Stephen, MD, FRCS(C) Sunnybrook Health Sciences Centre Associate Professor University of Toronto Toronto, Ontario Michael D. Stover, MD Professor Northwestern University Department of Orthopaedic Surgery Chicago, Illinois

10 10 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Final Program Thursday, June 01, 2017 Time Agenda Item Lecturer 08:00 08:10 Opening Comments Mayo Sagi 08:10 12:15 PELVIS Moderator: Nascone 08:10 08:25 Acute Management of Pelvic Ring Disruptions: Nascone Hemorrhage Control and Soft Tissue Management 08:25 08:40 Pelvis Ring Injuries Surgical Indications: Non-operative Reilly Management, In-situ Stabilization, or ORIF? 08:40 08:55 Decision-making in Pelvic Ring Fixation: Exposure, Sims Sequence, Fixation, Tactic Overview 08:55 09:10 Discussion 09:10 09:25 Anterior Ring Fixation: Symphyseal Dislocation, Roberts Ramus Fractures, Symphyseal Fracture-Dislocation 09:25 09:40 Posterior Pelvic Ring: Sacro-iliac Joint Dislocations / Stephen Fracture Dislocations 09:40 09:50 Posterior Pelvic Ring: Iliac Fractures (Technique of Bellino Reduction and ORIF, Role of LC-2 Type Screws) 09:50 10:10 Posterior Pelvic Ring: Sacral Fractures (Technique of Sagi Reduction, Iliosacral Screws, Tension Band Plating and Lumbo-pelvic) 10:10 10:25 Discussion 10:25 10:40 Break 10:40 12:15 Small Group Discussion Pelvic Ring Injuries 12:15 13:00 Lunch

11 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) 11 Final Program Thursday, June 01, 2017 (continued) Time Agenda Item Lecturer 13:00 18:15 ACETABULUM 13:00 16:00 Parcours on Radiology and Classification of Acetabular Fractures 13:00 13:10 Introduction to Understanding Normal Pelvis Anatomy and Radiology. Session Lead by Small Group Moderators in First Room 13:10 13:50 PARCOURS SESSION 1: ABC/AHT (Blue); Elementary Anterior Patterns (Yellow); TR Family (Red); Elementary Posterior (Orange) 13:50 14:30 PARCOURS SESSION 2: ABC/AHT (Orange); Elementary Anterior Patterns (Blue); TR Family (Yellow); Elementary Posterior (Red) 14:30 14:40 Coffee Break / Travel to Next Room (10 Minutes) 14:40 15:20 PARCOURS SESSION 3: ABC/AHT (Red); Elementary Anterior Patterns (Orange); TR Family (Blue); Elementary Posterior (Yellow) 15:20 16:00 PARCOURS SESSION 4: ABC/AHT (Yellow); Elementary Anterior Patterns (Red); TR Family (Orange); Elementary Posterior (Blue) 16:00 16:15 Break / Travel to Lecture Hall (15 Minutes) 16:00 18:15 ACETABULUM (continued) Moderator: Sims 16:15 16:30 Acetabular Fracture Decision-Making: Indications for Sims Surgery, Approach Choice Overview 16:30 16:45 Surgical Approach, Reduction Strategies and Olson Fixation: Posterior Column, Posterior Wall and Marginal Impaction 16:45 17:00 Surgical Approach, Reduction Strategies and Fixation: Johnson Transverse (Plus Posterior Wall) Fractures 17:00 17:15 Surgical Approach, Reduction Strategies and Fixation: Kregor T-shaped Fracture 17:15 17:30 Surgical Approach, Reduction Strategies and Fixation: Mayo AAPHT, Associated Both Column Fracture 17:30 17:45 Combined Pelvic Ring Injuries and Acetabular Fractures Stover 17:45 18:15 Questions, Panel Discussion Difficult Approach Choices

12 12 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Final Program Friday, June 02, 2017 Time Moderator Agenda Item 08:00 12:15 CADAVER DAY 1 (ACETABULUM) 08:00 10:15 Reilly Live Dissection R Ilioinguinal Participants Do R Ilioinguinal (Perform: Reduction Clamp Placement, Brim Plate) 10:15 10:30 Break 10:30 12:15 Sagi Live Dissection L AIP With Lateral Window Showing ASIS Osteotomy Participants Do AIP with ASIS Osteotomy (Perform: Reduction Clamp Placement, Contour Infra-pectineal Plate) 12:15 13:15 Reilly Lunch Video Dissection L Extended Ilio-femoral 13:15 17:30 CADAVER ACETABULUM (continued) 13:15 15:00 Stover Live Dissection R Kocher-Langenbeck Participants Do Kocher-Langenbeck (Perform: Reduction Clamp Placement (Jungbleuth (PC), Angled Jaw Through Notch (AC), Posterior Wall Buttress Plate Contouring) 15:00 15:15 Break 15:15 17:30 Mayo Live Dissection L Gibson With Trochanteric Osteotomy and Surgical Dislocation Participants Choose EIF or Gibson/ SHD for L-side (Perform: Reduction Clamp Placement, Femoral Head Fixations, Spring Plate for Superior Rim Fracture)

13 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) 13 Final Program Saturday, June 03, 2017 Time Moderator Agenda Item 08:00 12:00 CADAVER DAY 2: PELVIS 08:00 12:00 GROUP 1 (CADAVER LAB) 08:00 09:30 Leslie Pfanensteil (Extension of R Ilioinguinal From Day 1) With Symphyseal Plating Anterior Approach to R SI Joint With SI Plate (Avoid ASIS Osteotomy) 09:30 09:50 Break 09:50 12:00 Wilber Posterior Approach to R SI Joint With Clamp Placement Posterior Approach to Sacrum With Tension Band Plate 08:00 12:00 GROUP 2 (C-ARMS) 08:00 09:30 Rothberg LC-2 Screws Anterior External Fixators (Crest and AIIS) Ramus Fixation and Anterior Column Screws 09:30 09:50 Break 09:50 12:00 Kleweno Posterior Column Screws Iliosacral Screws and Transsacral Screws 12:00 13:00 Lunch

14 14 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Final Program Saturday, June 03, 2017 (continued) Time Moderator Agenda Item 13:00 17:00 CADAVER DAY 2: PELVIS (continued) 13:00 17:00 GROUP 1 (C-ARMS) 13:00 14:30 Rothberg LC-2 Screws Anterior External Fixators (Crest and AIIS) Ramus Fixation and Anterior Column Screws 14:30 14:50 Break 14:50 17:00 Kleweno Posterior Column Screws Iliosacral Screws and Transsacral Screws 13:00 17:00 GROUP 2 (CADAVER LAB) 13:00 14:30 Leslie Pfanensteil (Extension of R Ilioinguinal From Day 1) With Symphyseal Plating Anterior Approach to R SI Joint With SI Plate (Avoid ASIS Osteotomy) 14:30 14:50 Break 14:50 17:00 Wilber Posterior Approach to R SI Joint With Clamp Placement Posterior Approach to Sacrum With Tension Band Plate

15 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) 15 Final Program Sunday, June 04, 2017 Time Moderator Agenda Item Lecturer 08:00 09:40 SMALL GROUP DISCUSSION Small Group Acetabular Fracture Cases Definitive Management (From Parcours) 09:40 10:25 Kreder PELVIS SPECIAL TOPICS 09:40 09:55 The Geriatric Pelvis from Insufficiency Kreder Fractures to Real Trauma 09:55 10:10 Pediatric Pelvic Ring Injuries Rothberg 10:10 10:25 Discussion 10:25 10:40 Break 10:40 12:15 Collinge ACETABULUM SPECIAL TOPICS 10:40 10:55 Geriatric Acetabular Fractures Collinge When and How to Manage by ORIF/CRIF 10:55 11:10 Geriatric Acetabular Fractures Primary Ferguson THA Indications and Techniques 11:10 12:00 Complex Case(s) Panel Discussion 12:00 12:15 Final Comments Closing Mayo Sagi

16 16 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Location Key Activity Area Day Lectures Grand Ballroom 4 Orthopaedic Learning Center Thursday and Sunday Friday and Saturday Labs Orthopaedic Learning Center Friday and Saturday Breakfast Ballroom 1,2,3 Orthopaedic Learning Center In assigned Breakout rooms Lunch Ballroom 1,2,3 Orthopaedic Learning Center Thursday Friday and Saturday Sunday Thursday Friday and Saturday Discussion Groups Group A Group B Group C Group D Group E Group F Group G Group H Grand Ballroom 5 Grand Ballroom 6 Grand Ballroom 7 Grand Ballroom 8 Grand Ballroom 9 Grand Ballroom 10 Chicago F Chicago G Parcours Locations 13:00 13:50 13:50 14:30 14:40 15:20 15:20 16:00 Sticker Color Session 1 Session 2 Session 3 Session 4 Blue Gr. Ballroom 6 Gr. Ballroom 9 Chicago F Chicago G Orange Chicago G Gr. Ballroom 6 Gr. Ballroom 9 Chicago F Red Chicago F Chicago G Gr. Ballroom 6 Gr. Ballroom 9 Yellow Gr. Ballroom 9 Chicago F Chicago G Gr. Ballroom 6 Reception Ballroom Foyer Thursday Faculty Resource Center & AO Office River Cumberland NAME TAG IDENTIFICATION Gold Faculty White Participants Beige AONA Staff Grey Vendors Note: AO North America (AONA) will have official photographers/videographers present at this Course; therefore, please note that any photographs/videos taken at the meeting may be used in future AONA publications, on the AONA web site, or in other Society materials. Other picture taking and video or audio recording of lectures and labs is strictly prohibited. Please turn off all pagers and cellular phones.

17 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) 17 Presentation Information Faculty Disclosure It is the policy of AO North America to abide by the Accreditation Council for Continuing Medical Education Standards for Commercial Support. Standard 2: Disclosures Relevant to Potential Commercial Bias and Relevant Financial Relationships of Those with Control over CME Content, requires all planners, including course directors, chairs, and faculty, involved in the development of CME content to disclose their relevant financial relationships prior to participating in the activity. Relevant financial relationships will be disclosed to the activity audience. The intent of the disclosure is not to prevent faculty with relevant financial or other relationships from teaching, but to provide participants with information that might be of importance to their evaluation of content. All potential conflicts of interest have been resolved prior to the commencement of this activity. Conflict of Interest Resolution Statement When individuals in a position to control or influence the development of the content have reported financial relationships with one or more commercial interests, AO North America utilizes a process to identify and resolve potential conflicts to ensure that the content presented is free of commercial bias. Off-Label / Experimental Discussions Some medical devices used for teaching purposes and/or discussed in AO North America s educational activities may have been cleared by the FDA for specific uses only or may not yet be approved for any purpose. Faculty may discuss off-label, investigational, or experimental uses of products/devices in CME certified educational activities. Faculty have been advised that all recommendations involving clinical medicine in this CME activity are based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported or used in this CME activity in support or justification of a patient care recommendation conforms to the generally accepted standards of experimental design, data collection and analysis. Liability Statement AO North America faculty and staff assume no personal liability for the techniques or the use of any equipment and accessories used for teaching purposes in the laboratory. The certificate provided pertains only to the participants completion of the course and does not, in any way, attest to the proficiency of the participants clinical experience. Disclaimer AONA does not endorse nor promote the use of any product/device of commercial entities. Equipment used in this course is for teaching purposes only with the intent to enhance the learning experience. Laboratory Waiver To participate in this surgical skills course, you will be required to sign a waiver of liability prior to the course. In order to participate, AONA s policy mandates that every individual must wear appropriate protective garments provided by AONA during the lab sessions. Participants who do not sign the waiver and wear protective garments will not be allowed to participate in the laboratory sessions. Human Anatomic Specimens This course will involve exposure to and contact with human anatomic specimens. These specimens are being utilized for purposes of teaching and learning and are to be treated with the utmost respect. Participants should be familiar with and understand the potential risks involved and will be required to observe all customary safety procedures. AO North America gratefully acknowledges in-kind support for equipment and technical staff from DePuy Synthes and Siemens Healthcare. AO North America gratefully acknowledges funding for its educational activities from the AO Foundation. The AO Foundation receives funding for education from Synthes GmbH.

18 18 Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Future Courses Directly Provided by AO North America August 17 20, 2017 Bellevue, Washington Basic Principles of Fracture Management September 7 9, 2017 Glendale (Phoenix), Arizona Fragility Fractures and Orthogeriatrics September 14 17, 2017 Glendale (Phoenix), Arizona Foot and Ankle (with Human Anatomical Specimens) September 14 17, 2017 Glendale (Phoenix), Arizona Principles of Fracture Management Courses Part 1: Basic Principles Part 2: Advanced Principles October 26 29, 2017 Toronto, Ontario Principles of Fracture Management Part 1: Basic Principles Part 2: Advanced Principles November 9 12, 2017 Marco Island, Florida Trauma Update: Tips and Tricks for Orthopedic Surgeons November 30 December 3, 2017 Atlanta, Georgia Basic Principles of Fracture Management The activities will be approved for AMA PRA Category 1 Credit All courses subject to modification. To register, please visit the AO North America website at

19 AOTrauma membership Join us and share your passion As a member of AOTrauma you enjoy the following benefits: Direct access to the AOTrauma member network Fellowship opportunities AOTrauma News & quarterly AOTrauma newsletter Primal Pictures 3D human anatomy Online journals Ovid, Injury and Journal of Perioperative Practice Case Forum, AO Surgery Reference, AO Traumaline, online lectures/videos Special member offers

20 Final Program Pelvic & Acetabular Fracture Management (with Human Anatomic Specimens) Chicago Marriott O Hare Chicago, Illinois Course Location Chicago Marriott O Hare 8535 West Higgins Road Chicago, IL Phone: AO North America 1700 Russell Road Paoli, PA by AO North America. All rights reserved. N17US1101FP 05/17

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