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Pelvic Fractures

Pelvic fractures are the main cause of death in multiple trauma patients. 


Anatomy

Pelvic ring stability is provided by:

  1. Iliolumbar ligs.

  2. Dorsal sacroiliac ligaments

  3. sacrotuberous ligs

  4. Ventral sacroiliac ligs.

  5. sacrospinous ligs

  6. Posterosuperior interosseous ligs.


Classifications

1. Tile’s Classification (Tile, M.: Pelvic Ring Fractures: Should They Be Fixed? J. Bone Joint Surg., 70B:1-12, 1988)

TYPE A - Stable
A1-Fractures of the pelvis not involving the ring
A2-Stable, minimally displaced fractures of the ring
TYPE B - Rotationally unstable, vertically stable
B1-Open book
B2-Lateral compression: ipsilateral
B3-Lateral compression: contralateral (bucket-handle)
TYPE C - Rotationally and vertically unstable
C1-Rotationally and vertically unstable
C2-Bilateral
C3-Associated with an acetabular fracture

Young & Burgess Classification (J Trauma. 30:848-56. 1990)

stability can be judged by fracture pattern, direction of the force of injury, and by knowledge of pelvic ligamentous anatomy.



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