pelvis

Question 1

order of pelvic bone involvement (most common to least common)

Answer 1

pubic rami > ilium > ischium > acetabular > coccygeal > sacrum

Question 2

classification of pelvic fractures

Answer 2

tile’s classification

Question 3

tile’s classification of open fractures

Answer 3

type A:

• stable, minimally displaced
• e.g. pelvic rami fracture

type B:

• partially unstable
• rotationally unstable but vertically stable
• e.g. open book fracture

type C:

• unstable
• rotationally and vertically unstable
• a/w rupture of ipsilateral ligaments
• e.g. vertical shear fracture

Question 4

general complications of pelvic fractures

Answer 4

1) life threatening haemorrhage
2) fat embolism
3) bladder/bowel injuries
4) neurological damage
5) obstetrical damage
6) persistent SI joint pain
7) post traumatic hip arthritis (acetabular fractures)

Question 5

mechanism of injury of pelvic ring fractures

Answer 5

1) anteroposterior compression
2) lateral compression
3) vertical shear

Question 6

management of pelvic ring fractures

Answer 6

1) early
- pelvic binder + C clamp
- suprapubic cystomtomy in damage of urethra

2) treatment of fracture
undisplaced: 4 weeks rest in bed

anterior distruption without SI displacement

• open book injuries w gap <2cm: 6 week bed rest + elastic girdle
• more severe: external fixation + anterior bar connecting both iliac blades

displaced fractures with SI distruption
- anterior external fixation + screws across SI joint