Pelvic Fracture – Overview

A pelvic fracture is a serious injury that can lead to severe complications. This article provides basic information about pelvic fractures, including classification, mechanism, complications, and treatment.

1. Classification of Pelvic Fractures

Pelvic ring classification according to AO:

• Type A: Stable injury. The pelvic ligaments are intact.

• Type B: Partially unstable injury. The anterior ligament system is completely disrupted, while the posterior ligaments are partially disrupted.

• Type C: Completely unstable injury. The anterior and posterior ligament systems are completely disrupted.

Malgaigne fracture: This is a type of unstable pelvic fracture, often caused by a lateral compression mechanism. Malgaigne fracture includes injuries:

• Fracture of the ischiopubic rami, pubic symphysis of the anterior ring

• Fracture of the iliac wing of the posterior ring

2. Mechanism of Injury

• Direct force: Due to direct impact on the pelvic area.

• Indirect force: Due to force transmitted from other areas of the body to the pelvis, such as a fall from a height.

• Anteroposterior force: Force applied from front to back, such as a traffic collision.

• Lateral compression force: Force applied from one side to the other, such as a collision from the hip.

3. Complications

• Early complications:

• Deep vein thrombosis, pulmonary embolism

• Nerve, blood vessel damage

• Infection

• Late complications:

• Hip joint degeneration

• Avascular necrosis of the femoral head

• Hip joint stiffness

• Formation of iliac artery pseudoaneurysm

4. Treatment

Conservative treatment:

• Immobilization on a hard board, hammock, or continuous traction.

• External fixation with a screw splint.

Surgical treatment:

• Pelvic fixation with screws.

• Posterior fixation with iliac wing plates.

• Reduction and fixation of the acetabulum (if there is an acetabular fracture).

5. Diagnosis

• X-rays: Pelvic AP, oblique, and 3/4 views.

• CT scan: Provides detailed images of the injury.

• Ultrasound: Detects abdominal fluid, bladder rupture.

• Abdominal paracentesis: Confirms bladder rupture.

• Laparoscopy: Detects visceral injuries.

6. First Aid

• Control the patient’s shock.

• Immobilize the pelvis with a hard splint or board.

• Transport the patient to the hospital immediately.

7. Notes

• Pelvic fractures can lead to many serious complications.

• Timely and accurate treatment is crucial to minimize complications.

• After treatment, close monitoring is necessary to detect complications early.

8. Acetabular Fracture

• Most common type of acetabular fracture: Posterior wall fracture.

• Most common complication: Sciatic nerve injury.

• Surgical treatment indication: Displacement >3cm, or bone fragment trapped in the acetabulum, or after failure of conservative treatment.

9. Urethral Injury

• Clinical signs: Urethral pain, difficulty in catheterization, blood in the urine.

• Diagnosis: X-ray, ultrasound, urethroscopy.

• Treatment: Surgical repair of the urethra.

Note: This article is for informational purposes only. You should consult a doctor for diagnosis and treatment.