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Pelvic Ring Fractures

Pelvic Ring Fractures: Classification, Mechanisms, Clinical Features and Complications Anteroposterior force on pelvic ring (e.g. motorcycle accident) Diastasis (separation) of pubic symphysis Anterior Posterior Compression (APC) Axial shear force (e.g. fall) Superior or inferior displacement of hemipelvis Vertical Shear (VS) Grade 3: APC 2 with additional disruption of posterior sacroiliac ligaments Lateral compression force (e.g. automobile collides with pedestrian) Internal rotation of hemipelvis Lateral Compression (LC) Authors: Meaghan Mackenzie Stephanie de Waal Nojan Mannani Reviewers: Annalise Abbott Usama Malik Sunawer Aujla Mankirat Bhogal Michelle J. Chen Dr. Prism Schneider* Dr. Alyssa Federico* * MD at time of publication Grade 1: pubic symphysis diastasis < 2.5 cm Grade 2: pubic symphysis diastasis >2.5 cm, anterior sacroiliac diastasis, disruption of sacrospinous and sacrotuberous ligaments Grade 1: pubic rami fracture with ipsilateral sacral compression fracture Grade 2: pubic rami fracture with ipsilateral sacral and ilium fractures Grade 3: ipsilateral LC 1 or 2 injury and contralateral APC injury (windswept pelvis) Young-Burgess Classification of Pelvic Ring Fractures (Combination of any of the three classes can also occur) Blood vessels surrounding the fracture site rupture during injury Pelvic has capacity of hold large volume of blood Supporting ligaments are stretched or ruptured Damage to adjacent urogenital structures Gross hematuria Posterior urethral tear or bladder rupture Scrotal, labial or perineal hematoma Displacement of hemipelvis Limb-length discrepancy Damage to adjacent neurological structures Flank hematoma Potential hemorrhagic shock Loss of rectal tone or perirectal sensation L5 or S1 dermatomal paresthesia Chronic instability Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Nov 16, 2017; updated Nov 22, 2024 on www.thecalgaryguide.com