Pelvic injury

Question 1

Why emergency?

Answer 1

Profuse bleeding
*commonest: presacral venous plexus (sacroiliac joint)
++fracture
++visceral (not common)

Question 2

Pelvic anatomy

Answer 2

• 3 bones
• anterior hold
• posterior hold
• encases important structure (damage cause profuse bleeding)

Question 3

Classification Young-Burgees

Answer 3

LC

Question 4

Clinical features

Answer 4

d

Question 5

Physical examination

Answer 5

Pelvic spring: Loose, instability
Swelling: perineum, scrotal
Bruising, bogginess: loin, flank (retroperitoneal space)

Question 6

X-Ray

Answer 6

AP view
Inlet view: ala and iliac wings
Outlet ciew: sacrum and neuroforamina

Question 7

CT-Scan

Answer 7

Gold Standard

???

Question 8

Classification

Answer 8

Stable ring
Unstable ring
Haemodymamic unstable

Question 9

Management

Answer 9

1. Circumferential wrapping (over greater trochancter) : tengah2 pelvic binder
   - why not over pelvis: bawah terbukak
   - tamponade effect: haematoma fill up in finite space, compress venous plexus (compressible)
   - not prolonged: have to change to ex-fix
   - use for transport only
2. Pelvic clamp: difficult to put properly
3. Ex-fix: definitive?

Question 10

Mechanism of injury

Answer 10

LC: langgar dri tepi (commonest)
AP: langgar dri depan
Vertical Shear: fall from height