Pelvic fracture

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A hip fracture is a break from the pelvic bone structure. These include a sacral break, hip bone (iscium, pubis, ilium), or a coccyx. Symptoms include pain, especially with movement. Complications may include internal bleeding, bladder injury, or vaginal trauma.

Common causes include falls, motor vehicle collisions, pedestrians hit by vehicles, or direct injury. In younger people, significant trauma is usually required while in older people, less significant trauma can cause fractures. They are divided into two types: stable and unstable. Unstable fractures are subdivided into anterior posterior compression, lateral compression, vertical slide, and joint mechanism fracture. Diagnosis is suspected based on symptoms and examination with X-ray or CT scan confirmation. If a person is completely awake and has no pelvic medical imaging pain is not necessary.

Emergency care generally follows the support of an advanced trauma life. It starts with the effort to stop bleeding and replace fluids. Bleeding control can be achieved by using a pelvic binder or bed sheet to support the pelvis. Other attempts may include angiography of embolization or preperitoneal packing. After stabilization, the pelvis may require surgical reconstruction.

Pelvic fractures make up about 3% of adult fractures. Stable fractures generally have good results. The risk of death with unstable fractures is about 15%, while those who also have low blood pressure have a near 50% mortality risk. Unstable fractures are often associated with injury to other parts of the body.

Video Pelvic fracture

Signs and symptoms

Symptoms include pain, especially with movement.

Maps Pelvic fracture

Cause

Common causes include falls, motor vehicle collisions, pedestrians hit by vehicles, or direct injury. In younger people, significant trauma is usually required while in older people, less significant trauma can cause fractures.

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Pathophysiology

The bony pelvis consists of the ilium (ie, iliac wing), ischium, and pubis, which form the anatomical ring with the sacrum. This ring disorder requires significant energy. When it comes to stability and pelvic structure, or a pelvic girdle, understanding its function as support for the trunk and leg helps to recognize the effects of hip fracture on a person. The pubic bone, iscium and ilium form a pelvic girdle, fused into one unity. They stick to both sides of the spine and spin to create rings and sockets to place the hip joint. Attachment to the spine is important for directing the force into the stem of the foot when movement occurs, extending into the back of a person. This requires the pelvis to be strong enough to withstand pressure and energy. Various muscles play an important role in pelvic stability. Because of the forces involved, pelvic fractures often involve injury to organs contained within the pelvic bone. In addition, trauma to extra-pelvic organs is common. Pelvic fractures are often associated with severe bleeding due to the widespread blood supply to the region.

Classification

Pelvic fractures are most often described using either of the two classification systems. Different styles in the pelvis produce different fractures. Sometimes they are determined by stability or instability.

Tile classification

The Tile classification system is based on the integrity of the posterior sacroiliac complex.

In type A injury, the sacroiliac complex is intact. The pelvic ring has a stable fracture that can be managed nonoperatively. Type B injuries are caused by external or internal rotational forces resulting in a partial disturbance of the posterior sacroiliac complex. It's often unstable. Type C injuries are characterized by a complete disorder of the posterior sacroiliac complex and both are unstable rotational and vertical. This injury is the result of great strength, usually from a motor vehicle accident, falling from a height, or severe compression.

Young-Burgess Classification

The Young-Burgess classification system is based on the mechanism of injury: type I, II and III anteroposterior compression, lateral compression of types I, II and III, and vertical shear, or strength combinations.

A lateral compression fracture (LC) involves transverse fractures of the pubic flax, either ipsilateral or contralateral to a posterior injury.

• Grade I - Sacral compression is related to the impact side
• Level II - Posterior iliac fracture ("crescent") on the collision side
• Degree III - Related contralateral sacroiliac injuries

The most common force forces, lateral compression (LC), from side-impact auto accidents and pedestrian injuries, can produce internal rotation. The superior and inferior pubic flax may be fractured anteriorly, for example. Injuries from shear forces, such as falling from above, can cause ligament or bone disorders. When some power occurs, it is called a combined mechanical injury (CMI).

Open a book fracture

One particular type of pelvic fracture is known as an 'open book' fracture. This is often the result of severe impacts to the crotch (pubis), general motorcycle injury injuries. In this kind of injury, the left and right sides of the pelvis are separated in front and back, the front opening over the back, like an open book that falls to the ground and splits in the middle. Depending on the severity, this may require surgical reconstruction before rehabilitation. The anterior or posterior forces, such as head car accidents, usually cause an external rotation of the hemipelvis, an open book wound. Open fractures increase the risk of infection and bleeding due to injury to blood vessels, leading to higher mortality.

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Diagnosis

If a person actually wakes up and has no pain from pelvic pelvic medical pelvis is not necessary.

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Prevention

As the body ages, bones become weaker and more vulnerable and therefore more susceptible to fractures. Certain precautions are essential to reduce the risk of hip fractures. The most damaging is one from a car accident, a bike accident, or a fall from a tall building that can cause a high energy injury. This can be very dangerous because the pelvis supports many internal organs and can damage these organs. Falling is one of the most common causes of pelvic fractures. Therefore, appropriate precautions must be taken to prevent this from happening.

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Treatment

Fracture of the pelvis is often complicated and treatment can be a long and painful process. Depending on the severity, pelvic fractures can be treated with or without surgery.

Start

A high index of suspicion should be made for pelvic injury in patients with severe trauma. The pelvis should be stabilized with a pelvic binder. Ideally this should be a specially made tool, but improvised pelvic binders have also been used around the world for a good effect. Stabilization of the pelvic ring reduces blood loss from the pelvic vessels and reduces the risk of death.

Surgery

Surgery is often necessary for pelvic fracture. Many methods of pelvic stabilization are used including external fixation or internal fixation and traction. Often there are other injuries related to pelvic fracture so the type of surgery involved should be thoroughly planned.

Rehabilitation

Non-surgical pelvic fractures are treated with bed rest. Once the fracture is sufficiently cured, rehabilitation can begin by standing up first with the help of a physical therapist, followed by a walk start using a walker and eventually progressing to the stick.

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Complications

Complications tend to result in cases of excessive blood loss or puncture to certain organs, which may cause shock. Swelling and bruising may occur, especially in high-impact injuries. The pain in the affected area may vary where the severity of the impact increases the likelihood and may radiate if symptoms are aggravated when a person moves.

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Prognosis

The mortality rate in people with hip fractures is between 10 and 16 percent. However, death is usually caused by an associated trauma that affects other organs, such as the brain. Death rates due to complications that are directly related to hip fracture, such as bleeding, are relatively low.

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Epidemiology

About 10 percent of people seeking treatment at a 1st level trauma center after a blunted injury have a hip fracture. Motorcycle injuries are the most common cause of hip fractures, followed by injuries to pedestrians caused by motor vehicles, major falls (over 15 feet), and motor vehicle accidents.

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See also

• Coopernail mark

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References

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External links

• Wheeless 'Textbook of Orthopaedics: Fraktur pelvis

Source of the article : Wikipedia