医学PPT
11
Vertical shear: Mechanisms of injury: Force perpendicular to: Sacral plane SI-joint plane (s)
医学PPT
12
Rotationally and vertically (translationally) unstable fractures: Completely unstable pelvic fractures: Always complete disruption of: Posterior complex Pelvic floor Anterior complex > Completely unstable fracture
医学PPT

8
External rotationally unstable fractures: Partially stable pelvic fracture: Disruption of symphysis, sacrospinous ligament, all sacroiliac ligaments: > Open book injury with: Massive external rotation Flexion > Transition to vertical/translational instability
医学PPT
6
External rotationally unstable fracture: Partially stable pelvic fractures: Disruption of symphysis only: > Slight external rotation > Widening of symphysis max. 2.5 cm = Open book injury
医学PPT
4
Partially stable pelvic fractures: Rotationally unstable: Open book fractures > external rotation Lateral compression fractures > internal rotation
医学PPT
10
Internal rotationally unstable fractures: Partially stable pelvic fracture: Crush of lateral sacrum Disruption of posterior sacroiliac ligament Always anterior lesion: Transsymphyseal Transpubic > Lateral compression injury Always pelvic floor intact!
医学PPT
9
Internal rotation: Mechanisms of injury: Direct pressure to iliac crest Force against greater trochanter > femoral head > acetabulum Force parallel to sacral plane through SI.joint(s)
骨盆及髋臼骨折
Fractures of Pelvis and Acetabulum
王满宜
北京积医水学PP潭T 医院
1
Fractures of Pelvis
医学PPT
2
Pelvic pathology: Undisplaced/minmally displaced/displaced: Stable fracture Partially stable fracture (rotational) Completely unstable (rotational and vertically/translationally)
Isolated iliac wing fractures Undisplaced pubic ramii fractures Transverse fractures of sacrum below pelvic ring Os coccygis fractures All pelvic ligaments intact!
医学PPT
3
Unstable pelvic fractures: Partially stable: Rotationally unstable: External/internal rotation (lateral compression) Flexion/extension Abduction/adduction Completely unstable: Rotationally and vertically (translationally) unstable
医学PPT
7
External rotationally unstable fractures: Partially stable pelvic fracture: Disruption of symphysis, sacrospinous ligament and anterior sacroiliac ligament: > Open book injury Massive external rotation > PSIS abuts sacrum: External rotational instability
医学PPT
5
External rotation: Mechanisms of injury: Posterior crush Direct pressure ASIS External rotation through femur(s) > Rupture symphysis/sacrospinous lig./anterior sacroiliac lig Always posterior and interosses sacroiliac ligaments intact!