Review Question - QID 1165

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Pelvic Ring Fractures Definitive Treatment Nonoperative QID: 1165 (OBQ04.60)

QID 1165 (Type "1165" in App Search)

A 40-year-old male laborer sustained a fall from height and has isolated pelvic pain. He is otherwise hemodynamically stable. A radiograph is shown in Figure A. A stress examination under anesthesia does not show any further anterior diastasis or posterior pelvic ring displacement. Computed tomography reveals no asymmetry of the sacroiliac joints. What is the most appropriate management of this injury?

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protected weight-bearing and pain control

85%

1644/1938

open reduction and internal fixation

12%

233/1938

skeletal traction followed by open reduction and internal fixation

11/1938

pelvic external fixation

26/1938

pelvic external fixation followed by sacroiliac screws

10/1938

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This patient sustained an open-book pelvic fracture with a pubic symphysis diastasis of less than 2.5cm. From the Young and Burgess classification, he has anteroposterior compression (AP) type 1 injury. Treatment of this is protected weight-bearing and symptomatic treatment. Stress examination can be utilized in order to ensure that the injury is, in fact, a APC-1 injury, and not a more severe posterior injury that would require operative intervention.

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