Review Question - QID 8199

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Pelvic Ring Fractures QID: 8199 (SAE12TR.61)

QID 8199 (Type "8199" in App Search)

Figure 61 is the radiograph of a 34-year-old woman who was involved in a rollover motor vehicle accident. On arrival at the trauma center she is hypotensive and tachycardic. An abdominal CT scan reveals a spleen laceration. The patient remains hypotensive despite resuscitation and is taken to surgery for an emergent laparotomy and splenectomy. After surgery her delta base is -9 mmol/L. What is the most appropriate initial management of her pelvic ring injury?

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Application of a pelvic binder

21%

142/686

Application of skeletal traction

26%

179/686

Open reduction and internal fixation

15/686

Placement of percutaneous iliosacral screws

15/686

Placement of an anterior pelvic external fixator

47%

324/686

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The patient has a displaced iliac wing and bilateral rami fractures with superior migration of the right hip. To prevent further deformity, the patient's right hip should be placed into skeletal traction. A pelvic binder may worsen the deformity because of the iliac wing fracture. Anterior external fixation is problematic with an iliac wing fracture. Although the patient will eventually require open reduction and internal fixation and/or placement of iliosacral screws, she must be stabilized and resuscitated prior to this treatment.

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