Pelvic fractures - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2022-08-03T19:43:43Z

Differential Diagnosis

← Older revision		Revision as of 19:43, 3 August 2022
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Abdominal trauma DDX}}		{{Abdominal trauma DDX}}
			{{Lower GU trauma DDX}}
	{{Hip pain DDX}}		{{Hip pain DDX}}

Rossdonaldson1: /* Evaluation */

2021-03-17T22:33:03Z

Evaluation

← Older revision		Revision as of 22:33, 17 March 2021
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	==Evaluation==		==Evaluation==
			[[File:Acetabularfx.png\|thumb\|alt=Acetabular fracture (red arrow)\|Right [[acetabular fracture]] (arrow)]]
	*[[Pelvic X-ray]] (plain films)		*[[Pelvic X-ray]] (plain films)
	**AP - Obtain in all unconscious blunt trauma patients		**AP - Obtain in all unconscious blunt trauma patients

Rossdonaldson1: /* Background */

2021-03-17T22:27:00Z

Background

← Older revision		Revision as of 22:27, 17 March 2021
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	==Background==		==Background==
	[[File:Skeletal pelvis-pubis.png\|thumb\|The skeleton of the human pelvis: 1. Sacrum; 2. Ilium; 3. Ischium; 4. Pubic bone (4a. corpus, 4b. ramus superior, 4c. ramus inferior, 4d. tuberculum pubicum); 5. Pubic symphysis, 6. Acetabulum (of the hip joint), 7. Foramen obturatum, 8. Coccyx/tailbone; Dotted. Linea terminalis of the pelvic brim.]]
	~~[[File:Slide12DEN.jpg\|thumb\|Pelvis anatomy, medial view.]]~~
	~~[[File:Slide14DEN.jpg\|thumb\|Pelvis anatomy, lateral view.]]~~
	*3-Month mortality is three times higher in trauma patients with pelvic fractures<ref>Giannoudis PV, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007 Oct;63(4):875-83. http://www.ncbi.nlm.nih.gov/pubmed/18090020</ref>		*3-Month mortality is three times higher in trauma patients with pelvic fractures<ref>Giannoudis PV, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007 Oct;63(4):875-83. http://www.ncbi.nlm.nih.gov/pubmed/18090020</ref>
	*2 fractures will cause disruption of the pelvic ring		*2 fractures will cause disruption of the pelvic ring
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	**Especially with post ring fracture, upper sacral fracture		**Especially with post ring fracture, upper sacral fracture
	*[[Thoracic aorta rupture]] (1.5%)		*[[Thoracic aorta rupture]] (1.5%)

			{{Pelvic fracture types}}

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Differential Diagnosis */

2021-03-17T22:22:55Z

Differential Diagnosis

← Older revision		Revision as of 22:22, 17 March 2021
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Abdominal trauma DDX}}		{{Abdominal trauma DDX}}

	{{Hip pain DDX}}		{{Hip pain DDX}}

Rossdonaldson1: /* Background */

2021-03-17T22:13:59Z

Background

← Older revision		Revision as of 22:13, 17 March 2021
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	==Background==		==Background==
	[[File:Skeletal pelvis-pubis.png\|thumb\|The skeleton of the human pelvis: 1. Sacrum; 2. Ilium; 3. Ischium; 4. Pubic bone (4a. corpus, 4b. ramus superior, 4c. ramus inferior, 4d. tuberculum pubicum); 5. Pubic symphysis, 6. Acetabulum (of the hip joint), 7. Foramen obturatum, 8. Coccyx/tailbone; Dotted. Linea terminalis of the pelvic brim.]]		[[File:Skeletal pelvis-pubis.png\|thumb\|The skeleton of the human pelvis: 1. Sacrum; 2. Ilium; 3. Ischium; 4. Pubic bone (4a. corpus, 4b. ramus superior, 4c. ramus inferior, 4d. tuberculum pubicum); 5. Pubic symphysis, 6. Acetabulum (of the hip joint), 7. Foramen obturatum, 8. Coccyx/tailbone; Dotted. Linea terminalis of the pelvic brim.]]
	[[File:Slide12DEN.jpg\|thumb\|Pelvis, medial view.]]		[[File:Slide12DEN.jpg\|thumb\|Pelvis anatomy, medial view.]]
			[[File:Slide14DEN.jpg\|thumb\|Pelvis anatomy, lateral view.]]
	*3-Month mortality is three times higher in trauma patients with pelvic fractures<ref>Giannoudis PV, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007 Oct;63(4):875-83. http://www.ncbi.nlm.nih.gov/pubmed/18090020</ref>		*3-Month mortality is three times higher in trauma patients with pelvic fractures<ref>Giannoudis PV, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007 Oct;63(4):875-83. http://www.ncbi.nlm.nih.gov/pubmed/18090020</ref>
	*2 fractures will cause disruption of the pelvic ring		*2 fractures will cause disruption of the pelvic ring

Rossdonaldson1: /* Background */

2021-03-17T22:12:45Z

Background

← Older revision		Revision as of 22:12, 17 March 2021
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	==Background==		==Background==
	[[File:Skeletal pelvis-pubis.png\|thumb\|The skeleton of the human pelvis: 1. Sacrum; 2. Ilium; 3. Ischium; 4. Pubic bone (4a. corpus, 4b. ramus superior, 4c. ramus inferior, 4d. tuberculum pubicum); 5. Pubic symphysis, 6. Acetabulum (of the hip joint), 7. Foramen obturatum, 8. Coccyx/tailbone; Dotted. Linea terminalis of the pelvic brim.]]		[[File:Skeletal pelvis-pubis.png\|thumb\|The skeleton of the human pelvis: 1. Sacrum; 2. Ilium; 3. Ischium; 4. Pubic bone (4a. corpus, 4b. ramus superior, 4c. ramus inferior, 4d. tuberculum pubicum); 5. Pubic symphysis, 6. Acetabulum (of the hip joint), 7. Foramen obturatum, 8. Coccyx/tailbone; Dotted. Linea terminalis of the pelvic brim.]]
			[[File:Slide12DEN.jpg\|thumb\|Pelvis, medial view.]]
	*3-Month mortality is three times higher in trauma patients with pelvic fractures<ref>Giannoudis PV, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007 Oct;63(4):875-83. http://www.ncbi.nlm.nih.gov/pubmed/18090020</ref>		*3-Month mortality is three times higher in trauma patients with pelvic fractures<ref>Giannoudis PV, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007 Oct;63(4):875-83. http://www.ncbi.nlm.nih.gov/pubmed/18090020</ref>
	*2 fractures will cause disruption of the pelvic ring		*2 fractures will cause disruption of the pelvic ring

Rossdonaldson1: /* Background */

2021-03-17T22:11:23Z

Background

← Older revision		Revision as of 22:11, 17 March 2021
Line 1:		Line 1:
	==Background==		==Background==
			[[File:Skeletal pelvis-pubis.png\|thumb\|The skeleton of the human pelvis: 1. Sacrum; 2. Ilium; 3. Ischium; 4. Pubic bone (4a. corpus, 4b. ramus superior, 4c. ramus inferior, 4d. tuberculum pubicum); 5. Pubic symphysis, 6. Acetabulum (of the hip joint), 7. Foramen obturatum, 8. Coccyx/tailbone; Dotted. Linea terminalis of the pelvic brim.]]
	*3-Month mortality is three times higher in trauma patients with pelvic fractures<ref>Giannoudis PV, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007 Oct;63(4):875-83. http://www.ncbi.nlm.nih.gov/pubmed/18090020</ref>		*3-Month mortality is three times higher in trauma patients with pelvic fractures<ref>Giannoudis PV, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007 Oct;63(4):875-83. http://www.ncbi.nlm.nih.gov/pubmed/18090020</ref>
	*2 fractures will cause disruption of the pelvic ring		*2 fractures will cause disruption of the pelvic ring

Elcatracho: /* Management */

2021-02-10T14:52:05Z

Management

← Older revision		Revision as of 14:52, 10 February 2021
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	***Wrap with sheet or pelvic binder: Place pelvic binder over greater trochanters		***Wrap with sheet or pelvic binder: Place pelvic binder over greater trochanters
	***Do not over-reduce a lateral compression fracture (places increased strain on post pelvis)		***Do not over-reduce a lateral compression fracture (places increased strain on post pelvis)
	***Placing pelvic binder in vertical shear injury may worsen fracture		***Placing pelvic binder in vertical shear injury (fall from height) may worsen fracture
	*Anticipate hypotension: 80-90% Venous plexus bleeding, 10-20% Arterial bleeding		*Anticipate hypotension: 80-90% Venous plexus bleeding, 10-20% Arterial bleeding
	*[[FAST exam]] to rapidly detect hemoperitoneum		*[[FAST exam]] to rapidly detect hemoperitoneum

Mholtz: Text replacement - "-->" to "→"

2017-02-08T17:39:45Z

Text replacement - "-->" to "→"

← Older revision		Revision as of 17:39, 8 February 2017
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	*Anticipate hypotension: 80-90% Venous plexus bleeding, 10-20% Arterial bleeding		*Anticipate hypotension: 80-90% Venous plexus bleeding, 10-20% Arterial bleeding
	*[[FAST exam]] to rapidly detect hemoperitoneum		*[[FAST exam]] to rapidly detect hemoperitoneum
	**If hemoperitoneum is ~~present-->~~ OR		**If hemoperitoneum is present→ OR
	**If vital signs are ~~unstable-->~~ OR for damage control laparotomy, not CT<ref>Davis, J. W., Moore, F. A., McIntyre, R. C., Cocanour, C. S., Moore, E. E. and West, M. A. (2008) ‘Western Trauma Association Critical Decisions in Trauma: Management of Pelvic Fracture With Hemodynamic Instability’, The Journal of Trauma: Injury, Infection, and Critical Care, 65(5), pp. 1012–1015.</ref>		**If vital signs are unstable→ OR for damage control laparotomy, not CT<ref>Davis, J. W., Moore, F. A., McIntyre, R. C., Cocanour, C. S., Moore, E. E. and West, M. A. (2008) ‘Western Trauma Association Critical Decisions in Trauma: Management of Pelvic Fracture With Hemodynamic Instability’, The Journal of Trauma: Injury, Infection, and Critical Care, 65(5), pp. 1012–1015.</ref>
	**If vital signs are stable and no ~~hemoperitoneum-->~~ CTAP with IV contrast		**If vital signs are stable and no hemoperitoneum→ CTAP with IV contrast
	***Contact IR for possible pelvic angiographic embolization		***Contact IR for possible pelvic angiographic embolization
	*Pre-peritoneal packing can rescue failed angiography (usually in venous bleeding)		*Pre-peritoneal packing can rescue failed angiography (usually in venous bleeding)

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-25T08:10:53Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 08:10, 25 July 2016
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	{{Hip pain DDX}}		{{Hip pain DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*[[Pelvic X-ray]] (plain films)		*[[Pelvic X-ray]] (plain films)
	**AP - Obtain in all unconscious blunt trauma patients		**AP - Obtain in all unconscious blunt trauma patients