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Pelvis Injuries

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short presentation on the pelvis Injuries and Management in general , about bladder Injury, urethral injuries

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Pelvis Injuries

  1. 1. Injuries of the pelvis Prepared by ; Dr.Seerwan M J
  2. 2. Injuries of the pelvis 1. Introduction & Surgical Anatomy 2. Instability 3. Clinical Assessment 4. Stable and unstable injuries 5. Management
  3. 3. Introduction & Surgical Anatomy • • • • • 5% of all skeletal injuries Important ! 2/3 occur in RTA pedestrian 10% associated visceral Inj. 10 % Mortality
  4. 4. Introduction & Surgical Anatomy • Stability depends on the Ligaments & bone
  5. 5. Introduction & Surgical Anatomy • Common iliac artery, lumber & sacral plexus bladder , urethra.
  6. 6. Instability & trauma Anterior force Vertical shear Lateral foces
  7. 7. Clinical Assessment • Fracture pelvis Should be suspected in : – Abdominal or LL injuries – RTA, FFH Patient have severe pain, swelling, bruising of lower abdomen Inspection (lower abd., thigh, perineum, scrotum , vulva) Priority is to the patients’ general condition and blood loss , resuscitation before examination.
  8. 8. Clinical Assessment • • • • • • • Abdomenal examination Pelvic ring Rectal examination Urine color (no catheter should be inserted) Bladder injuries Neurological
  9. 9. Clinical Assessment- radiology
  10. 10. Clinical Assessment
  11. 11. best demonstrates ring configuration of pelvis, & narrowing or widening of diameter of ring is immediately apparent. - evaluates for posterior displacement of pelvic ring or opening of pubic symphysis
  12. 12. ,shows the anterior ring superimposed on the posterior ring. - evaluates for vertical shift of pelvis (migration of hemipelvis); - proximal or distal displacements of anterior or posterior portion of ring are best appreciated on this view; - sacrum appears in its longest dimension, w/ neural foramina evident.
  13. 13. shows iliopectineal line anterior column of pelvis & posterior wall; -
  14. 14. shows ilioischial line (posterior) column & anterior wall;
  15. 15. Stable & unstable Injuries Stable injuries Unstable injuries 1.ANTEROPOSTERIOR COMPRESSION (APC) INJURIES; APC I, APCII 1.APCIII 2.LATERAL COMPRESSION (LC) INJURIE; LCI,LCII 2.LCIII 3.VERTICAL SHEAR (VS) INJURIES Full weight bearing without the risk of pelvic deformity
  16. 16. 1.Early management 4.Treatment of fracture Mx 3.Mx of the urethra and bladder 2.Mx of sever bleeding

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