MOD 5 - Pelvic Fractures

Stable Pelvic Fractures (DERTC)

• a fractured pelvis that can withstand normal forces without deformation; involve a single break along the peripheral margins

• MOI = moderate trauma to the pelvis

• Reduction of the fracture and surgical intervention, with a screw or plate

• Neurological problems leading to bladder problems, post-surgical bowel obstruction

Avulsion Fractures (DERTC)

• seen mostly in young athletes, considered stable fx, can occur in the ASIS, AIIS, the ischial tuberosities and GT/LT.

• MOI = forceful contraction of the muscle

• rest and reduction of activity

• generally heal well

Unstable Pelvic Fractures (DT)

• with breaks in the anterior and posterior arches of the pelvic ring; categorized according to the MOI

• high risk of morbidity due to increased blood loss

Anteroposterior Compression (DERTC)

• results in a “sprung” or "open book" pelvis which is a widening of the pubic symphysis and anterior sacroiliac joints

• MOI = extreme force applied to the pelvis in an AP or PA direction

• Surgical plating may be required if there are associated genitourinary injuries

• Hemorrhage, genitourinary and rectal injuries

Lateral Compression of the Pelvis (DETC)

• ilium wings folding, sacral fractures, SI joint widening; superior and inferior pubic rami fractures associated

• MOI = mild to moderate trauma, with the force being applied in a lateral to medial direction

• Surgical intervention, external fixation

• Vascular injuries, genitourinary injuries, or neurological damage

Most common type of pelvic fracture

Lateral Compression

Vertical Shearing of the Pelvis (DETC)

• highly unstable and result in fractures along the axis, pubic rami, SI joints and sacrum; associated heavy bleeding

• MOI = severe axial force, for example, a fall from a height

• Surgical intervention

• Ongoing low back pain. Some pelvic obliquity with or without a limp. Poor function related to nerve injuries

Combined Mechanical Force Fractures (DETC)

• These fractures often include head and chest injuries as well as injuries to the abdomen and extremities

• MOI = combination of forces from various directions.

• Stabilization of the pelvic ring

• Ongoing pain, neurological damage.