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Pelvic ring fractures (Clinical presentation (Inspection: leg length…
Pelvic ring fractures
Clinical presentation
Inspection: leg length discrepancy, signs of bleeding e.g. ecchymosis, haematoma, and lacerations
Movement: testing stability with gentle rotational force, external rotation of leg
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Other exams: neuro (L5 (foot drop, paraesthesia down back+ medial foot), S1 (inability to lift heel, paraesthesia down back + lateral foot)), urogenital (vaginal, urethral), and abdo (rectal).
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Prognosis
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Mortality rate 15-25% for closed fractures, as much as 50% for open fractures
Anatomy
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In a trauma, 90% of blood loss occurs from the veins and 10% from the artery
The venous plexus run along the inside of the pelvic ring. In fractures these plexus' stretch with boney disruption leading to haemorrhage
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Background
Associated injuries: urogenital injuries in 12-20% (especially males), other trauma related injuries also occur
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Investigations
Trauma
AP pelvis (symmetry, rotation, displacement)
Bloods: VBG, group and save/cross match, FBC, coags, BHCG
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Classification
Young Burgess
First classifies fracture into 1 of three groups based on direction: AP compression, lateral compression or vertical shear
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