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PELVIC FRACTURE
SUPERVISOR:
DR. ERWIEN ISPARNADI, SP. OT
Angeline Rosa 2016.04.2.0011
Angga Yogi Laksmana 2016.04.2.0012
PELVIC FRACTURE
Pelvic fracture
Fractures of the pelvis account for less than 5% of all skeletal injuries, but it
is important because it associated with:
tissue injuries
blood loss
Shock
Sepsis
ARDS
Urogenital trauma
TYPE A TRAUMA
Severe Shock (-)
Pain in activity
Palpation : tenderness (+)
Pelvic visceral damaged : rare
Xray : Fracture (+)
Clinical Manifestations
PHYSICAL
EXAMINATION
- Lower limb length discrepancy and malrotation, and
neurology
- The abdomen, e.g. Tenderness, distention, external sign of
trauma
Diagnosis
PELVIC XRAY
AP
Inlet Oblique
view D/S
Outlet
view
CT SCAN
Because of the complexity of this type of injury, a CT scan is commonly
ordered for pelvic fractures. A CT scan will provide a more detailed, cross-
sectional image of the pelvis.
Management
Management
young burgess classification
Management
young burgess classification
Management
Urogenital injuries
Present in 12-20% of patients with pelvic fractures
higher incidence in males (21%)
Includes
posterior urethral tear
most common urogenital injury with pelvic ring fracture
bladder rupture
may see extravasation around the pubic symphysis
associated with mortality of 22-34%
Diagnosis
made with retrograde urethrocystogram
indications for retrograde urethrocystogram include
blood at meatus
high riding or excessively mobile prostate
hematuria
Treatmen
surgical repair
rupture should be repaired at the same time or prior to definitive fixation in order to minimize
infection risk
Complications
Ilio
Vesica
femoral
vein
urinaria
Early thrombosis tears
Complications
Rectum
Urethral &
tears vaginal
injury
Avascular Heterotrofic
Late necrosis osteogenic
compliactions
Secondary Skoliosis
osteoarthritis kompensatoar
Sacral & Coccygeus Injury
Acetabulum fractures can involve one or more of the two columns, two walls or roof
within the pelvis
fractures occur in a bimodal distribution:
high energy trauma in younger patients (e.g., motor vehicle accidents)
low energy trauma in elderly patients (e.g., fall from standing height)
Judet and Letournel Classifications
Judet and Letournel Classifications
Management
Nonoperative :
protected weight bearing for 6-8 weeks
Indications:
patient factors
high operative risk (e.g., elderly patients, presence of
DVT)
morbid obesity
open contaminated wound
late presenting > 3weeks
Operative treatment