Pelvis Injuries

Question 1

What is the intended action of a pelvic binder?

Answer 1

1. Prevents movement of fracture segments
2. Reduces pelvic volume and stabilizes fracture ends
3. Decreases volume of blood loss
4. Adds overall stability

Question 2

What type of pelvic fracture should not have a pelvic binder?

Answer 2

Lateral compression pevlic fractures
- already rotated internally
- may cause further harm

Question 3

Application of pelvic binder

Answer 3

Folded bed sheet with towel clips or a commercially available pelvic binder at the level of the greater trochanters

Question 4

What are the types of pelvic fractures?

Answer 4

• Lateral compression fracture
• anterior-posterior compression fractures (aka open book)
• vertical shear fractures
• iliac wing
• single pubic rami/ischium
• ischium body
• sacral
• coccyx
• Anterior superior iliac spine
• ischial tuberosity fracture
• acetabular fracture

Question 5

MOI and prevalence of lateral compression fracture

Answer 5

MOI: MVC where car is broadsided or pedestrian is struck from the side

Incidence: MC type 60-70% with an 8% mortality

Question 6

MOI and prevalence of anterior-posterior compression injuries, or open book fractures:

Answer 6

MOI: head on MVC. Force is delivered in an anteroposterior direction

Prevalence: 25%

Question 7

MOI and prevalence of vertical shear fractures

Answer 7

MOI: fall/jump from height. Force is delivered in a vertical plane

Incidence: least common type 5%

Question 8

MOI of lilac wing fractures

Answer 8

Direct trauma, usually lateral to medial

Question 9

MOI for single pubic rami or ischium fracture

Answer 9

Fall or direct trauma in elderly
Exercise induced stress fracture in young adult or pregnant woman

Question 10

MOI of ischium body fracture

Answer 10

external trauma or fall in sitting position
- least common pelvic fracture

Question 11

MOI of sacral fracture

Answer 11

Transverse: direct AP trauma
Upper Transverse: fall in fixed position

Question 12

MOI of coccyx fracture

Answer 12

Fall in sitting position

Question 13

Who is more likely to get coccyx fractures?

Answer 13

Women

Question 14

MOI for anterior superior iliac spine fracture

Answer 14

forceful satorious muscle contraction
E.g. adolescent sprinter

Question 15

Anterior inferior iliac spine fracture MOI

Answer 15

Forceful rectus femoris muscle contractions
E.g. adolescent soccer player

Question 16

Ischial tuberosity fracture MOI:

Answer 16

Forceful contraction of hamstring

Question 17

MOI of acetabular fracture

Answer 17

MVC: fracture force is transmitted laterally through the hip of posteriorly through the femur.
- knee vs dashboard

Question 18

Acetabular fractures are commonly associated with?

Answer 18

Other injuries
- pelvic
- femur
- hip
- knee