Pelvic Fractures Questions & Answers

Updated: Feb 26, 2018
  • Author: George V Russell Jr, MD; Chief Editor: William L Jaffe, MD  more...
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Questions & Answers

Overview

How do pelvic fractures occur?

What causes hemorrhages in pelvic fractures?

What causes pelvic deformities in pelvic fractures?

How have pelvic fractures been treated?

What factors have caused an increase in operative management of pelvic fractures?

What are the benefits of operative management of pelvic fractures?

What is the anatomy relevant to pelvic fractures?

How are the pelvic ligaments categorized in pelvic fractures?

What is the anatomy of the sacroiliac ligaments relevant to pelvic fractures?

What is the anatomy of the sacrospinous and sacrotuberous ligaments relevant to pelvic fractures?

What is the anatomy of the symphysis pubis relevant to pelvic fractures?

What is the role of the anatomic role pelvis?

What are the vascular structures in relevant to pelvic fractures?

What are the somatic segmental branches associated with the vascular structures of pelvic fractures?

What are the visceral branches associated with the vascular structures of pelvic fractures?

What are the limb and perineal branches associated with the vascular structures of pelvic fractures?

What is the anatomy of the lumbosacral plexus relevant to pelvic fractures?

What is the anatomy of the ilioinguinal and iliohypogastric nerves relevant to pelvic fractures?

What are the neurological structures of the lumbar plexus relevant to pelvic fractures?

What is the anatomy of the ventral branches of the lumbar plexus relevant to pelvic fractures?

What is the anatomy of the branches of the sacral plexus relevant to pelvic fractures?

What is the anatomy of muscle groups relevant to pelvic fractures?

What causes low-energy pelvic fractures?

What causes high-energy pelvic fractures?

What is the incidence of pelvic fractures?

What is the prognosis of pelvic fractures?

How does injury pattern affect the prognosis of pelvic fractures?

How does neurologic injury affect the prognosis of pelvic fractures?

What are the mortality risks associated with pelvic fractures?

Presentation

How do most pelvic fractures present?

What is the Advanced Trauma Life Support (ATLS) and how is it used in the management of pelvic fractures?

Which soft tissue injuries may be present in pelvic fractures?

What is the role of manual palpation in the assessment of pelvic fractures?

How are urethral injuries identified in pelvic fractures?

How is the extent of skeletal injuries assessed in pelvic fractures?

Which neurovascular injuries may be present in pelvic fractures?

Where do neurologic injuries occur in pelvic fractures?

What classification systems have been developed for pelvic fractures?

What is the basis of the Pennal and Tile classification of pelvic fractures?

What are type A pelvic fractures?

What are the type B pelvic fractures?

What are the type C pelvic?

What are the Young-Burgess classification subgroups of pelvic fractures?

How are vertical shears characterized in pelvic fractures?

Workup

What is the role of lab studies in the workup of pelvic fractures?

What is the role of anteroposterior (AP) pelvic radiograph in the workup of pelvic fractures?

What is the role of inlet pelvic radiographs in the workup of pelvic fractures?

What is the role of outlet pelvic radiograph in the workup of pelvic fractures?

What is the role of lateral sacral radiograph in the workup of pelvic fractures?

What is the role of CT scanning in the workup of pelvic fractures?

What are the benefits of CT scanning in the workup of pelvic fractures?

What is the role of pelvic angiography in the workup of pelvic fractures?

What is the role of retrograde urethrography in the workup of pelvic fractures?

What is the role of cystography in the workup of pelvic fractures?

Treatment

Which factors have increased the use of operative management for pelvic fractures?

What are the benefits of operative management of pelvic fractures?

How is pelvic stability defined in pelvic factures?

How is instability defined in pelvic fractures?

What will the future of pelvic fractures management involve?

What is the role of computer-assisted surgery in the treatment of pelvic fractures?

What is the initial management of pelvic fractures?

What is assessed following initial resuscitation and stabilization of patients with pelvic fractures?

What is the focus of initial management of pelvic fractures?

How is pelvic volume decreased in the initial management of pelvic fractures?

What is the role of pneumatic antishock garments in the initial management of pelvic fractures?

What is the primary goal for the treatment of pelvic fractures in the acute setting?

What are disruptions of the symphysis pubis in pelvic fractures?

When is surgical stabilization of symphysis pubis disruptions indicated in pelvic fractures?

What are the surgical options for symphyseal disruptions in pelvic fractures?

What is the role of an external fixator in the surgical therapy of pelvic fractures?

When is open reduction with internal fixation (ORIF) the preferred surgical therapy for pelvic fractures?

What is the role of implants in the surgical therapy of pelvic fractures?

What are pubic ramus pelvic fractures?

What are the treatment options for pubic ramus pelvic fractures?

What is the role of intramedullary fixation in the treatment of pelvic fractures?

What are iliac wing pelvic fractures?

When is surgery indicated for iliac wing pelvic fractures?

How are iliac wing pelvic fractures stabilized?

What are crescent pelvic fractures?

How are crescent pelvic fractures stabilized?

What are the advantages of a supine patient position in the surgical treatment of crescent pelvic fractures?

When is isolated percutaneous treatment of crescent pelvic fractures indicated?

How do sacroiliac (SI) joint disruptions occur in pelvic fractures?

Why is surgery the recommended treatment for SI pelvic fractures?

How is surgery for SI joint pelvic fractures performed?

How are sacroiliac (SI) joint pelvic fractures stabilized?

How is reduction of the dislocated ilium to the sacrum achieved in the treatment of pelvic fractures?

What is the role of iliosacral screws in the treatment of pelvic fractures?

What is the role of imaging in the treatment of sacroiliac joint pelvic fractures?

What are the classifications of sacral pelvic fractures?

When is operative stabilization indicated in the treatment of sacral pelvic fractures?

What are the treatment options for sacral pelvic fractures?

How is stabilization obtained after sacral pelvic fracture reduction?

What is the role of iliosacral screws in the treatment of sacral pelvic fractures?

What is the role of neurodiagnostic monitoring in the treatment of pelvic fractures?

What is the role of traction in the treatment of pelvic fractures?

What is the role of deep venous thrombosis (DVT) prophylaxis in the preoperative management of pelvic fractures?

What is the role of hematocrit screening in the treatment of pelvic fractures?

What is included in the preoperative management of pelvic fractures with neurologic injuries?

When are anteroposterior (AP) pelvis radiographs indicated in the preoperative management of pelvic fractures?

What are the benefits of preoperative templating to a skeletal model in the management of pelvic fractures?

How is the operative table selected for treatment of pelvic fractures?

How is prone positioning achieved for the surgical treatment of pelvic fractures?

How is neurologic monitoring performed during surgery for pelvic fractures?

When are postoperative radiographs obtained for pelvic fractures?

How is postoperative pain controlled in pelvic fractures?

What is the role of deep venous thrombosis (DVT) prophylaxis in the postoperative management of pelvic fractures?

How common are muscle ruptures and hernias in pelvic fractures?

What is the incidence of neurologic injuries in pelvic fractures?

What causes femoral nerve palsies in patients with pelvic fractures?

How common is postoperative wound infection in pelvic fractures?

How common are nonunion and malunion in pelvic fractures?

What is the prevalence of proximal deep vein thrombosis (DVT) in patients with pelvic fractures?

What is the incidence of pulmonary embolism (PE) in pelvic fractures?

What is the prevalence of genitourinary complications in patients with pelvic fractures?

What is the prevalence of dyspareunia and erectile dysfunction in patients with pelvic fractures?

What is included in the long-term monitoring following treatment of pelvic fractures?