PELVIC RING INJURY

DEFINITION

Is break of the bony structure of the pelvic.

Are usually due to a high energy injury

ARTERY

Superior gluteal artery, inferior gluteal artery, iliac artery, internal pudendal artery
dan organ visceral.
CLASSIFICATION
To fully appreciate the causation and management of pelvic
fractures, it is important to have an understanding of the classification
of pelvic fractures

• THE YOUNG AND BURGESS -> BASE ON THE MECHANISME OF

INJURY

• TILE CLASSIFICATION -> PROVIDES AN ASSESSMENT OF STABILITY OF

THE PELVIS
YOUNG AND BURGESS
• ANTERO POSTERIOR COMPRESSION (APC)
• APC I < 2.5cm OF WIDENING AT THE PUBIC SYMPHYSIS
• APC II SYMPHYSIS WIDENING > 2.5cm W/ AN ANTERIOR WIDENING OF A SIJ
• APC III WIDENING SYMPHYSIS > 2.5cm W/ A DISLOCATION OF A SIJ
• LATERAL COMPRESSION (LC)
• LC I RAMI FRACTURE AND IPSILATERAL ANTERIOR ALAR FRACTURE
• LC II RAMI FRACTURE AND IPSILATERAL POSTERIOR ILIUM FRACTURE DISLOCATION
• LC III IPSILATERAL LATERAL COMPRESSION AND CONTRALATERAL APC PATTERN INJURY
(WINDSWEPT PELVIS). Fig
• VERTICAL SHEAR
• USUALLY SEEN AFTER A FALL FROM HEIGHT, LANDING ON ONE LEG LEADING TO ONE
HEMIPELVIS BEING DRIVEN UP
X
X
TILE CLASSIFICATION
STABLE OR UNSTABLE

Give an accurate assessment of pelvis stability

TYPE A (STABLE)
TYPE (PARTIAL STABLE)
TYPE C (UNSTABLE)
TYPE A

• A1 – fracture not involving pelvic ring (e.g. avulsion or iliac wing

fracture)
• A2 – iliac wing fracture or anterior rami fractures
• A3 – transverse sacral fracture
TYPE B
• B1 – unilateral anterior disruption of posterior structures (SIJ
widening or sacral fracture)
• B2 – unilateral SIJ joint fracture / subluxation (anterior ring rotation)
• B3 – bilateral SIJ / sacral fracture / subluxation
TYPE C
• C1 – complete unilateral posterior disruption
• C2 – complete unilateral posterior disruption with contralateral partial
disruption
• C3 – complete bilateral posterior disruption.
CLINICAL FEATURES AND CLINICAL
ASSESSMENT
Radiography
Plain radiography: 5 views are necessary
1. Anteroposterior view.
2. Pelvic inlet view in which the tube is cephalad to the pelvis and
tilted 45° downwards.
3. Pelvic outlet view in which the tube is caudad to the pelvis and
tilted 45° upwards.
4. Right oblique view.
5. Left oblique view.
COMPLICATION
• Uretheral stricture
• Impotence
• Venous thromboembolisme
• Nerve injury
• Infection
• Non-union
TERIMAKASIH