Pelvic Fractures


Frequency

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.

Associated injury

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%.

Investigations

Xrays- Standard AP, Inlet view, Outlet view

CT scan and reconstructions

Angiography

Tile classification

Tile proposed a classification based on a continuum of stability.

Type Description
A Stable
A1 Fracture not involving the ring

  • avulsion fracture of ASIS,AIIS or ischium
  • fracture of iliac wing
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
C1 Unilateral

Iliac Fracture

Sacroiliac Fracture-dislocation

Sacral Fracture

C2 Bilateral
C3 Associated with acetabular fractures

Complications