Review Note

Pelvic Ring Fractures

• Causes – high energy trauma e.g., motor vehicle accident, fall from height.
• Commonly associated w/ other injuries e.g., chest injury, urogenital injury.
• Clinical features – pain in pelvic area, inability to bear weight, pelvic instability, hematomas around pelvic area, possibly visible deformity, possibly hemodynamic instability (damage to large BV).
• Pelvis becomes unstable if there is disruption of pelvic ring in at least 2 places.
• CT should be done to accurately see all fractures & their extent.
  
  

• Initial management
  • Stabilization w/ pelvic binder or sheet
  • External fixation – unstable pelvic fracture w/ ongoing blood loss, patient undergoing emergent laparotomy.
  • Resuscitation w/ i.v. fluids, blood products.
    
    
    
    
• Definitive treatment
  • Nonoperative – stable closed fractures
    • Bed rest + weight bearing as tolerated.
  • Operative – unstable fractures, open fractures.
    • ORIF – plates, screws
• Analgesia, thromboprophylaxis, rehabilitation & follow-up imaging for all patients.