Pelvis fracture

Question 1

the 3 basic views for acetabulum

Answer 1

AP
Obturator oblique
Iliac oblique

Question 2

6 Lines on AP

Answer 2

• Iliopectineal line (integrity of anterior column of acetabulum)
• Ilioischial line (vertical to the u) anterior border of the obturator foramen, integrity of posterior column.
• Radiological roof, most cranial part of acetabulum
• anterior rim of the acetabulum (or acetabulo-obturator line)
• posterior rim of the acetabulum (lateral aspect of the posterior wall)
• Teardrop (u), superposition of anterior and posterior horns of the articular surface.

Question 3

Obturator oblique

Answer 3

45° anterior shift of patient
or
45° view from lateral

ASIS and PSIS are alined

1. Pelvic brim
2. posterior border of the acetabulum
3. obturator foramen
4. acetabular roof

Question 4

Iliac oblique

Answer 4

45° posterior shift of patient
or
45° view from medial

1. Posterior border of entire innominate bone, posterior spine, greater ischiatic notch, ischial spine and tuberosity

Question 5

Pelvic ring AO

Answer 5

61

Question 6

Intact posterior notch

Answer 6

61A

Question 7

Incomplete disruption of posterior notch

Answer 7

61B

Question 8

Complete disruptino of posterior notch

Answer 8

61C

Question 9

61A1

Answer 9

61A1.1 ASIS
61A1.2 AIIS
61A1.3 Ischial tuberosity

Question 10

61A2

Answer 10

61A2.1 Iliac wing
61A2.2 unilateral ilio-ischopubis
61A2.3 bilateral ilio-ischiopubis

Question 11

61A3

Answer 11

Transverse Sacrum fracture (S3, S4, S5, Coccyx)

Question 12

61B

Answer 12

rotation instable

translation stable

Question 13

61 C

Answer 13

rotation and translation instable

Question 14

Open book

Answer 14

can be a B or C fracture

Question 15

3 sources of bleeding

Answer 15

Venous (venous presakral plexus)
Arterial (20%) mostly iliaca interna
Fracture

Question 16

Corona mortis

Answer 16

anastomosis between internal iliac branch (obturator) and external iliac branch (inferior epigastric)

Question 17

Nerve lesions

Answer 17

mostly due to traction mechanism
in 10% of overall pelvic fractures
30-60% of C fractures

Question 18

Type of approaches for Acetabulum

Answer 18

Ilio-inguinal (anterior)
Kocher Langenbeck (posterior, CHL)
Ilio-femoral (anterior and posterior)