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Ortho Trauma > Young-Burgess Classification for Pelvic Ring Injuries > Flashcards

Young-Burgess Classification for Pelvic Ring Injuries Flashcards

1
Q

Symphysis disruption leads to what instability

A

Can get up to 2.5 cm of diastasis, any more than that means that the sacrotuberous and sacrospinous ligaments are disrupted

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2
Q

APC-1

A

Symphysis

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3
Q

APC-2

A

Symphysis >2.5 cm, longitudinal rami fxs, Ant. SI ligaments open, sacrotuberous and sacrospinous ligaments disrupted

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4
Q

APC-3

A

Symphysis >2.5 cm, longitudinal rami fxs, Ant. and Post. SI ligaments disrupted, sacrotuberous and sacrospinous ligaments disrupted, needs a pelvic binder

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5
Q

What is a straddle fracture?

A

Free floating symphysis, >50% have bladder/urethra injury, nondisplaced only need sx care, needs possible laparatomy because of uro injury

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6
Q

How to treat APC fxs

A

Close the diastasis

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7
Q

LC-1

A

Oblique/Transverse rami fx and ipsilateral anterior sacral ala compression fx

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8
Q

LC-2

A

Rami fx and ipsilateral post. ilium fx dislocation (crescent fx)

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9
Q

LC-3

A

LC-2 + contralateral APC (Windswept pelvis)

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10
Q

Vertical Shear

A

Posterior and superior directed force, highest risk of hypovolemic shock

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11
Q

MCC of pelvic ring injuries

A

Lateral Compression mechanism

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12
Q

Sacrotuberous and sacrospinous ligaments in LC

A

Intact

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13
Q

Vertical shear fx also called

A

Malgaigne

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14
Q

VS consists of

A

Disruption of ant. and post. pelvis along with sacrotuberous and sacrospinous ligaments

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15
Q

VS mechanism

A

Typically caused by falls

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16
Q

VS initial management

A

Femoral traction to pull the elevated side into place

17
Q

Inlet view is taken how and what does it show

A

Beam is turned 45 degrees caudad. Gets a good view of the AP relationships of the pelvis, good for seeing APC injuries. Also good for seeing rotation about the pelvis. Diastasis. Sacrum is seen on end.

18
Q

Outlet view is taken how and what does it show

A

Emitter is turned 20-45 degrees cephalad. Good view of Vertical changes. Symphysis overlies S2 body.

19
Q

Most common arterial bleeders

A

Superior gluteal, internal pudendal, obturator, lateral sacral

20
Q

Leading cause of bleeding

A

Venous

21
Q

Nonop indications

A

If isolated ant. injuries: WBAT. If ipsi ant/post ring injuries, protected weight bearing

22
Q

Operative indications

A

Diastasis >2.5 cm!
Both ant & post. SI ligament disurption
Sacral fx >1 cm displacement

23
Q

Ex-fix through what

A

AIIS or iliac wing (AIIS is biomechanically stronger but less well clinically tolerated)

24
Q

Ex-fix major complication

A

LFCN injury

25
Q

Vertically unstable patterns with ant./post. dislocations operative tx

A

Anterior ring int. fixation and perc SI screw is most stable fixation construct

26
Q

Common complications

A

Life-threatening hemorrhage in APC II, APC III, LC III patterns; urogenital injury, DVT is most common if you dont use DVT ppx

27
Q

What are the unstable fracture types

A

APC II/III, LC II, LC III, vertical shear, combined mechanism

28
Q

What kind of rami fxs in LC

A

Horizontal (almost in coronal plane)

29
Q

XRs to get in sacral fxs

A

AP pelvis, inlet, outlet, and lateral views. Usually get sacral

30
Q

What kind of sacral compression from LC type injuries

A

Anterior impaction

31
Q

Sacral fx nonop indications

A

WBAT if fx incomplete (ilium contiguous with the intact sacrum). TTWB if complete fxs.

32
Q

Sacral fx op indications

A

Displaced >1 cm

33
Q

Sacral fx neurologic risks

A

Zone II displaced is highest incidence, L5 root usually involved with Zone II. Cauda equina seen with zone III injuries.

34
Q

How do you get a straddle injury

A

You slip in the bathtub

Ortho Trauma (6 decks)

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