Pelvic Fractures

Contents

Mechanism

high energy trauma (e.g. MVA), either direct or by force transmitted longitudinally through the femur

Clinical Features

local swelling, tenderness
pelvic instability, deformity of hips
only a management problem if they cause instability of the bony ring of the pelvis

Investigation

x-ray: AP, Judet (inlet and outlet)

Title Classification of Pelvic Fractures

Type	Stability	Description
A	Rotationally stable Vertically stable	A1: fracture not involving pelvic ring A2: minimally displaced fracture of pelvic right (e.g. ramus fracture)
B	Rotationally unstable Vertically stable	B1: open book B2: lateral compression – ipsilateral B3: lateral compression – contralateral
C	Rotationally unstable Vertically unstable	C1: unilateral C2: bilateral C3: associated acetabular fracture

Treatment

ABCDE
assess genitourinary injury (rectal exam, vaginal exam)
- if involved, the fracture is considered open
Type A: bedrest, mobilize with walking aids
Types B & C: external or internal fixation

Complications

hemorrhage (life threatening) – 1500-3000mL blood loss
bladder/urethral injury
neurological damage
obstetrical difficulties
persistent SI joint pain
post-traumatic arthritis of the hip with acetabular fractures injury to rectum

Attachments:

Pelvic Fractures.jpg (image/jpeg)

Pelvic Columns.jpg (image/jpeg)