Pelvic fractures account for 1-3% of all skeletal fractures and 2% of orthopedic hospital admissions. The frequency of pelvic fractures occurs in a bimodal pattern, with peaks observed in persons aged 20-40 years and later in individuals older than 65 years.
High-energy injuries that result in pelvic ring disruption are more likely to be accompanied by severe injuries . These are often the results of motor vehicle accidents. The reported range of mortality rates associated with pelvic ring fractures is 9-20%. The mortality rate among hemodynamically unstable patients has been reported to be 50%, whereas hemodynamically stable patients have a mortality rate of 10%.
Xrays- Standard AP, Inlet view, Outlet view
CT scan and reconstructions
Tile proposed a classification based on a continuum of stability.
|A1||Fracture not involving the ring
|A2||Stable minimally displaced ring fractures
|B||Rotationally unstable / Vertically stable|
|B1||Open book (external rotation)|
|B2||Lateral compression (internal rotation)|
|B3||Lateral compression (contra-lateral posterior and anterior fractures= bucket handle)|
|C||Rotationally and vertically unstable|
|C3||Associated with acetabular fractures|
- Non-union / malunion
- Infection- increased incidence associated with open bowel injury. 6% incidence
- Nerve palsy- usually peroneal component of sciatic nerve. 11.2% (17.4% of posterior fractures)
- Ectopic bone formation- 20%
- Thrombo-embolic problems
- urethral injury- About 1/3 of unstable fractures (13% overall)
- Impotence ~ 40%
- Post traumatic osteoarthritis- 4 – 15% dependent on quality of reduction
- Mortality- Overall 5 – 20%. Open fractures up to 42%