Pelvic Ring Fx

Question 1

Classification system

Answer 1

Young-Burgess

Question 2

APC I

Answer 2

Symphysis widening

Question 3

APC II

Answer 3

Symphysis widening >2.5cm
Ant SI joint diastasis, Post SI lig intact
Disruption of Sacrospinous and sacrotuberous lig
Tx: ant symphyseal plate or external fix +/- post fix

Question 4

APC III

Answer 4

Disruption of ant and post SI lig (SI dislocation)
Disruption of sacrospinous and sacrotuberous lig
-Associated with vascular injury
Tx: ant symphyseal multi-hole plate or ex-fix and post stabilization with SI screw or plate/screws

Question 5

LC I

Answer 5

Oblique or transverse ramus fx and ipsilateral ant sacral ala compression fx
Tx: non-op

Question 6

LC II

Answer 6

rami fx and ipsilateral ilium fx dislocation (crescent fx)

Tx: ORIF of ilium

Question 7

LC III

Answer 7

Ipsilateral compression and contralateral APC (windswept pelvis)
Common mech is rollover vehicle or ped vs auto
Tx: post stabilization with plate or SI screw. PP or open

Question 8

Vertical Shear

Answer 8

Post and superior directed force
Ass with highest risk of hypovolemic shock (63%); mortality rate up to 25%
Tx: post stabilization with plate/SI screw. PP or open