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Pelvic Ring Fractures: Multimedia
Updated: Feb 11, 2009
Multimedia
 | Media file 1: Anteroposterior (AP) compression injury as seen on an AP radiograph of the pelvis. Characteristic features of an AP compression injury include symphyseal and sacroiliac joint diastasis. In this patient, the pubic symphysis and right sacroiliac joint are widened. |
 | Media file 2: Windswept pelvis (lateral compression injury) as seen on a pelvic CT scan. The patient sustained a left lateral compression injury with internal rotation of the left hemipelvis and a characteristic sacral buckle fracture. Note the concomitant left sacroiliac joint diastasis. The lateral force vector continued across the pelvis to produce external rotation of the right hemipelvis and diastasis of the right sacroiliac joint. The combination of injuries resulted in a windswept pelvis. |
 | Media file 3: Vertical shear injury as seen on an anteroposterior radiograph of the pelvis. The left hemipelvis is displaced in a cranial direction, with associated sacroiliac joint diastasis. The vertically oriented fractures of the pubic rami usually are ipsilateral; however, in this patient, the rami fractures are contralateral. |
 | Media file 4: Pelvic ligaments as seen on an anterior view of the pelvis. The horizontally oriented anterior sacroiliac and sacrospinous ligaments resist rotation. The vertically oriented sacrotuberous ligaments resist vertical displacement. |
 | Media file 5: Pelvic ligaments as seen on a superior view of the pelvis. The posterior sacroiliac ligaments are the most important structures for pelvic stability. |
 | Media file 6: Pelvic ligaments as seen on a posterior view of the pelvis. The short and long posterior sacroiliac ligaments are the most vital structures for the preservation of pelvic ring stability. Note the iliolumbar ligament attachment to the L5 transverse process. An avulsion fracture at this site may be a sign of posterior ligamentous disruption. |
 | Media file 7: Anteroposterior compression injury as seen on an anteroposterior radiograph of the pelvis. The symphysis pubis is wider than 2.5 cm (double arrow). The right sacroiliac joint is diastatic (single arrow). This is a type II or type III injury, depending on the status of the posterior sacroiliac ligaments. |
 | Media file 8: Anteroposterior (AP) compression injury as seen on a pelvic CT scan. The location and degree of sacroiliac disruption is better seen on CT scans than on radiographs. The external rotation of the right hemipelvis is a characteristic finding in AP compression. A slight posterior displacement of the right, iliac side of the sacroiliac joint suggests ligamentous disruption (arrow). This represents a type III AP compression injury. |
 | Media file 9: Lateral compression injury as seen on an anteroposterior radiograph of the pelvis. Note the characteristic left sacral buckle fracture (long arrow) and the minimally overlapping left pubic rami fractures (short arrow). The sacral fractures may be subtle on radiographs. |
 | Media file 10: Lateral compression injury as seen on an inlet radiograph of the pelvis. The internal rotation of the left hemipelvis is better visualized by using the inlet view. The fractures of the left sacrum (long arrow) and left pubic rami (short arrows) are shown. |
 | Media file 11: Lateral compression injury as seen on a pelvic CT scan. The left sacral buckle (anterior crush) fracture is more readily apparent on the CT scan than on other images. |
 | Media file 12: Windswept pelvis (lateral compression injury) as seen on an anteroposterior radiograph of the pelvis. The patient had a left lateral compression injury. Note the internal rotation of the left hemipelvis and the overlapping left pubic rami fractures (double arrow). The pubic symphysis diastasis, rightward displacement of the pubic symphysis with external rotation of the right hemipelvis, and right sacroiliac joint diastasis (single arrow) are features of anteroposterior compression. The combination results in the characteristic appearance of the windswept pelvis. |
 | Media file 13: Windswept pelvis (lateral compression injury) as seen on a pelvic CT scan. The features of each component of the injury are seen to better advantage with CT. Note the internal rotation of the left hemipelvis and external rotation of the right hemipelvis (long arrows). Note also the left sacral buckle fracture (short white arrow) and the right sacroiliac joint diastasis (short black arrow). The left sacroiliac joint also is disrupted. |
 | Media file 14: Vertical shear injury as seen on an anteroposterior radiograph of the pelvis. The left hemipelvis is displaced in a cranial direction with associated sacroiliac joint diastasis (long arrow). The vertically oriented fractures of the pubic rami usually are ipsilateral; however, in this patient, the rami fractures are contralateral (short arrow). |
 | Media file 15: Vertical shear injury as seen on an outlet radiograph of the pelvis. The vertical (cranial) displacement of the left hemipelvis and pubic symphysis is better visualized by using the outlet view. In addition, a left iliac fracture is more readily apparent (large arrows). Left sacroiliac joint diastasis is seen (small arrow). |
 | Media file 16: Vertical shear injury as seen on a pelvic CT scan. A displaced vertically oriented fracture of the ilium extends to the left sacroiliac joint. |
 | Media file 17: Vertical shear injury as seen on a pelvic CT scan. A slightly more inferior image demonstrates anterior and posterior disruption of the left sacroiliac joint. The left hemipelvis is rotationally and vertically unstable. |
 | Media file 18: Vertical shear injury as seen on a pelvic CT scan. As also shown on the radiograph of this injury (see Image 14), a vertically oriented fracture of the right superior pubic ramus is depicted with cranial displacement of the pubic symphysis and left hemipelvis. |
 | Media file 19: Bilateral anterior inferior iliac spine avulsion fracture as seen on an anteroposterior radiograph of the pelvis. Hyperextension of the hip occurred in this patient during a motor vehicle collision. The injury resulted in avulsion fractures at the origins of both rectus femoris muscles. Note that the integrity of the pelvic ring is preserved. |
 | Media file 20: Iliac wing fracture as seen on an anteroposterior radiograph of the pelvis. A fracture of the left iliac wing occurred secondary to a direct blow to the left hemipelvis. The fracture does not involve the pelvic ring; therefore, the pelvis is stable. |
 | Media file 21: The anteroposterior image of the pelvis is routinely acquired as part of the initial radiographic examination of the pelvis. |
 | Media file 22: Compared with the anteroposterior view, the inlet perspective of the pelvis better demonstrates internal or external rotation and anteroposterior displacement of the hemipelvis. |
 | Media file 23: Cranial displacement of the hemipelvis is demonstrated better on this outlet view of the pelvis than on other images. In addition, the sacral neural foramina are better profiled. |
 | Media file 24: Diastasis of the symphysis pubis, which most commonly indicates an anteroposterior compression injury. |
 | Media file 25: The combination of a sacral buckle fracture and ipsilateral overlapping pubic rami fractures is characteristic of a lateral compression injury. |
 | Media file 26: Avulsion fractures of the pelvis (eg, from the anterior inferior aspect of the iliac spine) do not affect the integrity of the pelvic ring. Isolated iliac wing fractures may occur as a result of a direct blow without disruption of the pelvic ring. With iliac crest, anterior iliac spine, and ischial tuberosity avulsion fractures, the integrity of the pelvic ring is also maintained. |
More on Pelvic Ring Fractures |
| Overview: Pelvic Ring Fractures |
| Imaging: Pelvic Ring Fractures |
| Follow-up: Pelvic Ring Fractures |
 Multimedia: Pelvic Ring Fractures |
| References |
| « Previous Page |
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Further Reading
Keywords
pelvic ring fracture, pelvis fracture, blunt trauma, bladder rupture, vertical shear injury, anteroposterior compression injury, AP compression injury, lateral compression injury, pelvic hemorrhage, osseous pelvis, Young-Burgess classification, Tile classification, pubic diastasis, sacral buckle fracture, pubic rami fracture, iliac wing fracture
