Pelvic fractures Flashcards
Name the different classification system for pelvis fractures
Bucholz - based on the bone that is fractures
Letournel and Judent - based on site of injury
Young and Burgess - based on mechanism of injury (AP compression)
Tile - based on severity of instability
Muller as for TIle
AO
In AO classification what are TYPE A fractures
Fractures that has a stable and intact pelvic ring
Fractures are avulsion (1), Innominate bone fractures (2) and trasverse sacral fractures (type 3)
In AO classification what are Type B fractures?
Type B1: Open book fractures - through anterior SIJ , or sacral fracture
B2Allows rotation of half of the pelvis. SYmphysis and incomplete sacro-iliac region fractures
In AO classification what are TYPE C fractures?
Unstable, complete posterior disruption, allows rotation of half of pelvis, allows vertical displacement. Cannont walk on this fracture.
Posterior fracture and pubis too
(Iliac wing, or SIJ or sacrum
What do surgeon’s guide lines provide for Pelvis fracture surgery
Restrictions - A and PROM, muscle contraction limits, joint ROM limits timeframes
Surgical and post op procedures varies with?
Structure operated on, incisions, tissue status and quality found at surgery, variations on repairs, variations on hard ware
Are Pelvis fractures ever simple?
No, usually to fracture the pelvis it occurs due to massive trauma such as a car crash, they usually come in an ambulance with may ther injuries and major bleeding. FIrst need to stablise the patients and control bleeding (Haemostasis)
Explain part of the pelvic ring fracture fixation
They use a percutaneous intramedullary scre fixation
Run a fine wire along the path
the run a hollow screw over the wire
What are the two major classifications within the Letournel calssifications for Acetabular fractures?
Elementary
Associated
What classifications are under the elementary grouping
Anterior walle, anterior column, posteior wall, posterior columc, transverse
What are the classifications under the Associated Acetabuar fractures?
T-shaped, Anterior wall/ column plus hemitransverse, transverse and posterior wall, posterior column and wall
Both columns
What is a posterior column acetabular fracture?
Fracture line extends through roof of acetabular int obturator foramen and continues through the inferior pubic ramus
DUring the first 24-48 hours after pelvic fracture surgery waht is the post op care?
1v antibiotics, Anticoagulation (heparin, clexane), Wound drains, Vacuum seal, continuous passive motion?, no casts, no traction, X-ray or CT taken
What are the two basic post op care principles
Prevent Complications and Get ready to go home
What are some principles of post op care?
Sit out of bed early, mobilise as easrly as safely possible, commence in bed exercises too gradually increase independences, D/C planning
