Learning objectives
To identify pelvic ring fracture patterns on Computed tomography.
To classify the fracture patterns using Young & Burgess classification.
Background
Complex pelvic injuries are one of the most dangerous and deadly traumasituations to manage primarily because mortality rates are high due to rapid exsanguination,
difficulty to achieve hemostasis and associated injuries.
Hence a multidisciplinary approach is crucial.
(1)
There are many classifications for pelvic fracture patterns,
some are based on the mechanism of injury,
some on anatomical patterns and some are on the resulting instability requiring operative fixation.
The optimal treatment,
however,
should take into consideration the hemodynamic status,
the anatomic impairment of pelvic ring...
Findings and procedure details
CT Findings of Lateral compressiontype of injury
Type 1 (Figure 1): An impaction fracture of the anterior sacrum on the side of the compression is characteristic of a lateral compression type 1 injury,
with superior and inferior rami fractures most commonly seen in conjunction with a small “buckle” in the sacral ala.
Usually,
lateral compression type 1 injuries are stable and heal without any surgical intervention,
and they are distinct from the high-energy fractures seen in younger patients.
Type 2 (Figure 2): Lateral compression type...
Conclusion
Pelvic fracture patterns can be difficult to evaluate on Pelvic radiographs which are taken initially in the emergency department.
A CT based pattern approach can aid in a better and quicker diagnosis.
The management of pelvic trauma should take into consideration the anatomical and physiological derangement in a patient.
The Young and Burgess classification system provides information regarding causative forces and their biomechanical implications.
This classification system enables us to better evaluate pelvic ring injuries and also direct further imaging to look for associated musculoskeletal...
References
Khurana,
B.,
Sheehan,
S.E.,
Sodickson,
A.D.,
Weaver,
M.J.Pelvic ring fractures: what the orthopedic surgeon wants to know.Radiographics.2014;34:1317–1333.
Burgess,
A.R.,
Eastridge,
B.J.,
Young,
J.W.
et al,Pelvic ring disruptions: effective classification system and treatment protocols.J Trauma.1990;30:848–856.
Young,
J.W.,
Burgess,
A.R.,
Brumback,
R.J.,
Poka,
A.Pelvic fractures: value of plain radiography in early assessment and management.Radiology.1986;160:445–451.