PELVIC FRACTURES &
FIXATION DEVICES
J.E.Tannebaum PGY4 General Surgery
Pelvic Fractures

Lateral Compression
 Types
I-III
 Horizontally oriented pubic
fractures
 force is from side

Anteroposterior Compression
 Types
I-III
 Sagittal disruptive force
(MVAs)
 Anterior pelvic disruption

Vertical Shear
Lateral Compression

Horizontally oriented pubic fractures (force is from side)

Type I


Type II


Sacral compression fx on side of impact
Iliac wing fracture on side of impact
Type III

LC type I or II fracture + contralateral Anteroposterior Compression Fracture
Anteroposterior Compression

Type I



Type II



pubic rami or ligament disruption
Slight widening of symphysis
Iliac wings rotated externally “hinging” at SI joint posterior aspect
“Open Book”
Type III


Complete disruption of sacroiliac ligaments
unstable
Vertical Shear



Fall from heights
Anterior: both pubic ramis fractured
Posterior: SI complex or sacral fracture
Pelvic Stabilization


Goal: reduce pelvic volume to decrease
hemorrhage (earlier tamponade)
External Pelvic Fixation (EPF)
 Standard
 Invasive

Temporary stabilization
 Quickly
applied (5-60min)
 Lower transfusion volumes at 24h & 48h
 C-clamp
 T-pod
Journal of TRAUMA® Injury, Infection, and Critical Care • Volume 71, Number 6,
December 2011 EAST Pelvic Fracture Guidelines
Pelvic Stabilization
 “because
of their ease of use and fast
application, TPBs have largely replaced the
pelvic C-Clamp and EPF for early
mechanical stability in pelvic fracture”
Journal of TRAUMA® Injury, Infection, and Critical Care • Volume 71, Number 6,
December 2011 EAST Pelvic Fracture Guidelines
References

Wheeless’ Textbook of Orthopedics
 Accessed
online 11/27/12
 http://www.wheelessonline.com/ortho/classification_1


Young JW, Resnik CS. Fracture of the pelvis: current
concepts of classification. AJR, Dec 1990,
155:1169-1175.
Journal of TRAUMA® Injury, Infection, and Critical
Care • Volume 71, Number 6, December 2011
EAST Pelvic Fracture Guidelines