PELVIC FRACTURES &

FIXATION DEVICES
J.E.Tannebaum PGY4 General Surgery
Pelvic Fractures
Lateral Compression
Types I-III
Horizontally oriented pubic
fractures
force is from side

Anteroposterior Compression
Types I-III
Sagittal disruptive force
(MVAs)
Anterior pelvic disruption

Vertical Shear
 Lateral Compression
Horizontally oriented pubic fractures (force is from side)

Type I
Sacral compression fx on side of impact
Type II
Iliac wing fracture on side of impact
Type III
LC type I or II fracture + contralateral Anteroposterior Compression Fracture
 Anteroposterior Compression

Type I
pubic rami or ligament disruption
Slight widening of symphysis
Type II
Iliac wings rotated externally hinging at SI joint posterior aspect
Open Book
Type III
Complete disruption of sacroiliac ligaments
unstable
Vertical Shear

Fall from heights

Anterior: both pubic ramis fractured
Posterior: SI complex or sacral fracture
 Pelvic Stabilization
Goal: reduce pelvic volume to decrease
hemorrhage (earlier tamponade)
External Pelvic Fixation (EPF)
Standard

Invasive

Temporary stabilization
Quickly applied (5-60min)
Lower transfusion volumes at 24h & 48h
C-clamp
T-pod
Journal of TRAUMA Injury, Infection, and Critical Care Volume 71, Number 6,
December 2011 EAST Pelvic Fracture Guidelines
 Pelvic Stabilization
because of their ease of use and fast
application, TPBs have largely replaced the
pelvic C-Clamp and EPF for early
mechanical stability in pelvic fracture

Journal of TRAUMA Injury, Infection, and Critical Care Volume 71, Number 6,
December 2011 EAST Pelvic Fracture Guidelines
References
Wheeless Textbook of Orthopedics
Accessed online 11/27/12
http://www.wheelessonline.com/ortho/classification_1

Young JW, Resnik CS. Fracture of the pelvis: current

concepts of classification. AJR, Dec 1990,
155:1169-1175.
Journal of TRAUMA Injury, Infection, and Critical
Care Volume 71, Number 6, December 2011
EAST Pelvic Fracture Guidelines