Dr. Ebraheim’s educational animated video describes fracture injury conditions and treatment associated with the pelvis.
Stability of the pelvis. Integrity of the posterior weight-bearing SI complex.Transfer of weight-bearing forces from the spine to the lower extremities.
The pelvis is a ring.
•Anterior injury is obvious.
•Usually noted on radiographs
•Usually associated with posterior injury or fracture.
•Could be occult
•Always look at the back of the pelvis.
•Posterior gap or comminution = unstable.
•Posterior fracture is serious.
•Needs significant blood transfusion.
•Posterior fracture with disruption of the posterior ring complex is a serious injury as it leads to instability of the pelvis and can cause profuse bleeding.
•The resultant instability if not fixed surgically can cause late deformity, limb length discrepancy and pain.
Types of pelvic fractures
1-Anteroposterior compression (pubic rami fracture)
2-Anteroposterior compression (open book pelvis)
•“close the book”: pelvic binder and sling.
•Surgery if symphasis pubic diastasis is more than 2.5 cm.
•Anterior pelvic surgery such as external fixator or plates.
•The most common type of fracture and is usually impacted and not displaced.
•Has good prognosis and usually does not require surgical fixation.
4-Vertical shear fracture
•Needs surgery anteriorly and posteriorly
•Needs blood transfusion
•Initial external fixation may be needed to control the bleeding.
•Traction in the ER may reduce vertical displacement
•Decreases motion at fracture site
•Pelvic binder may be helpful.
Vertical shear fractures are stabilized surgically by
1-Anteriorly internal fixation with plates. Reduction of the fracture before fixation.
2-Posteriorly: posterior screw fixation