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18 Cards in this Set
- Front
- Back
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most common causes of traumatic pelvic fractures
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motorcycle
ped vs auto mvc crush injuries |
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risk factors for pelvic fracture morbidity and mortality
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high-velocity mvc
side impact vehicle incompatibility |
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clinical exam
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neuro deficit involving lumbosacral plexus
pelvic, flank, perineal contusions/ecchymoses/abrasions blood at urethral meatus blood in or around the rectum open wounds of groin, buttock, perineum leg length inequality or ER of one extremity abnormal pelvic motionon AP or lat compression of ant iliac spine and crests |
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most frequent cause of pelvic fracture hemorrhage
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venous
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myotomes of lower extremity
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L1-2: hip flexors
L3-4: quad/knee extension L4-5: ankle/toe dorsiflexion SI: ankle plantarflexion S2-3: toe plantarflexion |
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possible pelvic hemorrhage management protocol
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pelvic binder
pelvic ex fix angio pelvic packing |
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open pelvic fracture
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communication between a fracture fragment and the external environment or a pelvic visceral cavity
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when should diverting colostomy be performed
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within 6-8hr following injury - reduce sepsis and death
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defines good AP pelvis
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pubic symphysis colinear with sacral spinous processes
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Tile classification
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A: stable
1: avulsion 2: direct blow - iliac wing or ant ring (nondisplaced) 3: transverse sacral or coccyx fx B: rotationally unstable - incomplete post arch disruption, vertically stable 1: open book (ext rotation) 2: lateral compression (int rotation) -1: ipsilateral ant/post injuries -2: contralateral (bucket handle) injuries 3: bilaterally rotationally unstable - open book, LC, windswept (combo) C: unstable (complete post arch disruption) 1: unilateral -1: iliac fx -2: SI joint dislo -3: sacral fx 2: bilateral 3: associated acetab fx |
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Young and Burgess Classification
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LC: anterior injury = rami fx
I: sacral compression II: iliac wing (crescent) III: LCI or LCII with contralateral open book APC: anterior injury = symphysis diastasis/rami fx I: 1-2 cm diastasis, lig stretched but intact II: >2 cm diastasis, ant SI/SS/ST torn (post SI intact) III: >2 cm diastasis, ant&post SI/SS/ST torn VS: vertical displacement |
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sacral fractures
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zone 1: lateral to sacral foramina
zone 2: traverse one or more of sacral foramina zone 3: medial to sacral foramina and enter spinal canal |
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sciatic buttress
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extremely dense region of bone at superior aspect of the greater sciatic notch
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exiting structures through sciatic notch
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sciatic nerve
superior gluteal n/a inferior gluteal n/a internal pudendal n/a |
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primary stabilizing ligamentous structures of posterior pelvic ring
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anterior SI lig
intra-articular SI lig posterior SI lig sacrotuberous lig sacrospinous lig |
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indications for fixing ant ring injuries
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symphyseal dislo >2.5 cm
augment post fixation in vertically displaced locked symphysis pain/inability to mobilize |
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indications for fixing post ring injuries
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displaced iliac wing fx that enter/exit crest and greater sciatic notch or SI joint
disruption of post SI lig nonimpacted, comm, displaced sacral fx potential for vertical displacement U-shaped sacral fractures |
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indications for sacral fx stabilization
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vertical shear
nonimpacted/comm alar fx with ER U-shaped instability following anterior fixation |
