PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

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PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery

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Transcript of PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

Page 1: PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

PELVIC FRACTURES & FIXATION DEVICES

J.E.Tannebaum PGY4 General Surgery

Page 2: PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

Pelvic Fractures

Lateral Compression Types I-III Horizontally oriented

pubic fractures force is from side

Anteroposterior Compression Types I-III Sagittal disruptive force

(MVAs) Anterior pelvic disruption

Vertical Shear

Page 3: PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

Lateral Compression

Type I Sacral compression fx on side of impact

Type II Iliac wing fracture on side of impact

Type III LC type I or II fracture + contralateral Anteroposterior

Compression Fracture

Horizontally oriented pubic fractures (force is from side)

Page 4: PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

Anteroposterior Compression

Type I pubic rami or ligament disruption Slight widening of symphysis

Type II Iliac wings rotated externally “hinging” at SI joint posterior aspect “Open Book”

Type III Complete disruption of sacroiliac ligaments unstable

Page 5: PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

Vertical Shear

Fall from heights Anterior: both pubic ramis fractured Posterior: SI complex or sacral

fracture

Page 6: PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

Pelvic Stabilization

Goal: reduce pelvic volume to decrease hemorrhage (earlier tamponade)

External Pelvic Fixation (EPF) Standard Invasive

Temporary stabilization Quickly applied (5-60min) Lower transfusion volumes at 24h & 48h

C-clamp T-pod

Journal of TRAUMA® Injury, Infection, and Critical Care • Volume 71, Number 6, December 2011 EAST Pelvic Fracture Guidelines

Page 7: PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

Pelvic Stabilization

“because of their ease of use and fast application, TPBs have largely replaced the pelvic C-Clamp and EPF for early mechanical stability in pelvic fracture”

Journal of TRAUMA® Injury, Infection, and Critical Care • Volume 71, Number 6, December 2011 EAST Pelvic Fracture Guidelines

Page 8: PELVIC FRACTURES & FIXATION DEVICES J.E.Tannebaum PGY4 General Surgery.

References

Wheeless’ Textbook of Orthopedics Accessed online 11/27/12 http://www.wheelessonline.com/ortho/

classification_1 Young JW, Resnik CS. Fracture of the pelvis:

current concepts of classification. AJR, Dec 1990, 155:1169-1175.

Journal of TRAUMA® Injury, Infection, and Critical Care • Volume 71, Number 6, December 2011 EAST Pelvic Fracture Guidelines


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