Pelvis Fractures Flashcards
who do they occur in
higher energy in YP
older patients with osteoperosis can sustain pubic rami fractures from low energy injuries
why is it uncommon to only have one disurption in the pelvic bones
form a ring
lateral compression fracture
side impact where half of pelvis is displaced medially
Fractures through the pubic rami or ischium are accompanied by a sacral compression fracture or SI joint disruption.
vertical shear fracture
axial force on one hemipelvis (eg fall from height or rapid deceleration). hemipelvis displaced superiorly
Sacral nerve roots and lumbosacral plexus are at high risk of injury and major haemorrhage may occur. Leg on affected side will appear shorter.
anteroposterior compression fracture
may result in wide disruption of pubic symphysis - open book pelvic fracture
there is substantial bleeding, the pelvis can contain several litres of blood before clotting and tamponade occur
how are pelvic fractures treated
- what to do if there is continuous bleeding
- what exam must be performed
pelvic binder will hold reduction temporarily and allow clotting of vessels
continuous bleeding - angiogram and embolisation
PR exam to assess sacral nerve function (sphincter tone) and look for presence of blood - rectal tear makes it an open fracture
general surgical review is mandatory
how are low energy pubic rami fractures in elderly treated
tend to be minimally displaced lateral compression injuries and settle with conservative managment over time
who do acetabulum fractures occur in
usually high energy in YP, but also low energy in OP
how do acetabulum fractures occur
often posterior wall fractures are associated with hip dislocation (head of femur pushed out to back of joint)
eg flexed drivers knee collides wtih dashboard in road traffic accident
management of acetabulum fractures
- conservative if undisplaced
- ORIF in displaced/unstable
- THR
