Trauma: Pelvic Fractures

Trauma: Pelvic FracturesCreated OnMay 4, 2020Last Updated OnMay 4, 2020byadmin You are here: Main Radiology Trauma: Pelvic Fractures < All Topics Table of Contents Pelvic X-Ray X-ray is a quick and simple test that will detect the majority of pelvic fractures. They can be difficult to assess because of the complexity of the shape of the sacrum, pelvis and proximal femora. Pelvis Anatomy – Normal AP The 2 hemi-pelvis bones and the sacrum form a bone ring bound posteriorly by the sacroiliac joints and anteriorly by the pubic symphysis Each obturator foramen is also formed by a ring of bone Hemi-pelvis anatomy – Normal AP Each hemi-pelvis bone comprises 3 bones – the ilium, pubis and ischium The 3 bones fuse to form the acetabulum – the pelvic portion of the hip joint ASIS = Anterior Superior Iliac Spine = attachment site for sartorius muscle AIIS = Anterior Inferior Iliac Spine = attachment site for rectus femoris muscle Pubic ramus fracture Fractures seen in the superior or inferior pubic ramus are usually accompanied by another fracture of the other ramus on the same side. Very common fractures in the elderly. The obturator ring is incomplete on the right A fracture passes through the superior and inferior pubic rami Compare with the normal left side Pelvic fractures Fractures to the pelvis are highly variable in appearance depending on the mechanism and force of injury. Careful examination of the cortical surfaces of the bony rings will reveal most fractures. The extent of injury is often underestimated on plain radiographs. Acetabular fracture A tiny step in the cortical edge of the pelvic ring reveals a fracture which passes into the acetabulum The fracture passes to the obturator ring and then through the inferior pubic ramus Pelvis diastasis High force injury to the bony pelvis may result in “diastasis” (separation) at the pubic symphysis or a sacroiliac joint. Both the pubic symphysis and the right sacroiliac joint are widened There is complete separation of the right hemi-pelvis from the axial skeleton Avulsion injuries In young athletically active individual’s avulsion injuries may occur, most frequently at the ASIS, and occasionally at the AIIS. Sacral Fracture- AP Pelvis Loss of the smooth arcuate lines is a sign of sacral fracture...

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