22. Types, treatment and associated injuries of pelvic fractures.

Question 1

What are the types of pelvic fractures?

Answer 1

Stable: (can withstand normal physiological forces without deformation) Unstable:
• Rotationally
• Vertically OR
Type A → fracture that can be managed non-operatively
Type B → partial disruption of the posterior sacroiliac complex Type C → complete disruption of the posterior sacroiliac complex

Question 1

What kind of pelvic fracture can be caused by an anterior-posterior force?

Answer 1

External rotation of the hemipelvis

Question 2

What kind of pelvic fracture can be caused by a lateral compression force?

Answer 2

Impaction of the cancellous (spongy) bone

Question 3

What is the treatment of pelvic fractures?

Answer 3

ABCDE
Pelvic exam:
• Pelvic instability
• Massive flank or buttock contusions
• Swelling with hemorrhage
FIXATION:
External Sxation a construct along the anterior iliac crest. External Sxation can only be used for deSnitive Sxation of anterior pelvis injuries; it cannot be used as deSnitive Sxation of posteriorly unstable injuries
Internal Sxation this signiScantly increases the forces resisted by the pelvic ring compared with external Sxation

Question 4

What are the associated injuries of pelvic fractures?

Answer 4

MASSIVE BLOOD LOSS RISK (disruption of the posterior venous plexus) Neurologic injury lumbosacral plexus and nerve root injuries.
Genitourinary / GI injuries bladder injury/urethral injury