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Pelvic Fractures & fixation devices

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

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Pelvic Fractures & fixation devices

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  1. Pelvic Fractures & fixation devices J.E.Tannebaum PGY4 General Surgery

  2. Pelvic Fractures • Lateral Compression • Types I-III • Horizontally oriented pubic fractures • force is from side • AnteroposteriorCompression • Types I-III • Sagittal disruptive force (MVAs) • Anterior pelvic disruption • Vertical Shear

  3. 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)

  4. 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

  5. Vertical Shear • Fall from heights • Anterior: both pubic ramis fractured • Posterior: SI complex or sacral fracture

  6. 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

  7. 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

  8. 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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