Pelvic fractures post RTA

Question 1

what is the classification system used?

Answer 1

Young Burgess

Based on direction of the force

Question 2

Types of pelvic instability

Answer 2

Rotational instability: the pelvis is unstable to internal or external rotation of the hemipelvis

Vertical instability: the pelvis is unstable to cephalad-caudad movement

Question 3

LC injuries signs

Answer 3

Transversely oriented and overlapping fractures of the pubic rami
Buckling fracture of the sacrum

Question 4

LC injuries - STABILITY

1 - 3

Answer 4

1. stable
3. windswept

Question 5

APC injury signs

Answer 5

widened pubic symphysis or widened pubic rami fractures; more severe injuries may cause SIJ disruption

Question 6

Antero-posterior compression injuries may lead to external rotation of the hemipelvis about the SIJ. This leads to

Answer 6

increased volume of the pelvis, and allows significant pelvic haemorrhage to occur.

Question 7

VS - vertical shear - main finding on imaging

Answer 7

key imaging finding is cranial displacement of the iliac wing relative to the sacrum

Vertically orientated fractures of the pubic rami
Vertical displacement of the pubic symphysis

Question 8

important clue on VS injuries

Answer 8

avulsion of the tip of the transverse process of L5 which is avulsed by the iliolumbar ligament.

Question 9

In CT artierial phase - bleeding appears as

Answer 9

dense contrast in the soft tissues

Question 10

how to work out if something is bone or bleeding?

Answer 10

HU - bone is 300 - 700

Contrast is up to 200 - 300

Question 11

Within the pelvis, the most commonly injured organs are

Answer 11

the bladder and urethra

Question 12

Outside the pelvis, the most commonly injured organs are

Answer 12

Liver, lung, brain and spine

Lower limb