2. PELVIC INJURY
Pelvic injuries can be a life threatening
especially in a remote environment
where we are far from help.
To safely manage a casualty with a
pelvic injuries a particular
understanding of the cause,
recognition and treatment.
3. The pelvis
The pelvis is a large, stable and strong ring-like
structure.
Each ilium is joined to either side of the sacrum; the
base of the spine
The ring is completed at the front by a cartilage bridge
called the symphysis pubis.
This flexible joint is necessary for the pelvic to flex and
expand during childbirth.
4. Bones of the pelvis
The bones that makes up the pelvis include:
The sacrum ( the largest triangle shaped bone at the
base of the spine)
The coccyx ( tailbone)
The hipbones, which includes the ilium, ischium and
the pubis.
Together, these bones form what’s known as pelvic
ring.
It is a highly stable structure that protect many
important nerves, blood vessels and organs.
It also acts as an anchor for the muscles of the leg.
5.
6. Pelvic fracture
This is when there is fracture(break) in
one or more of the bones that makes up
the pelvis.
The pelvis is the area of the body below
the abdomen that’s located between
the hipbones.
Pelvic fractures can be mild or severe
7. Types of pelvic fracture
Since the pelvis is made of multiple bones, there are
many types of pelvic fractures.
In general, there are also several kinds of bone
fractures depending on the pattern of the break
including.
1. Close or Open (compound) fracture
2. Complete fractures
3. Displaced fractures
4. Partial fracture
5. Stress fractures
6. Avulsion fracture
8. Classification of pelvis fracture
The pattern that the fracture has, a pelvic fracture is
classified into stable and unstable
Stable pelvic fracture:
- There is usually only one break in the pelvis, and the
broken parts of the bones are not displaced.
Unstable pelvic fracture:
-there are often two or more breaks, and the ends of
broken parts of the bones are displaced.
9. Sign and symptoms
The symptoms of a pelvic fracture depend on how mild
or severe it is. The sign and symptoms of pelvic fracture
include:
Experiencing pain in the groin, hip and/or lower back
Intense pain when walking or moving the legs
Numbness or tingling in the groin area or leg
Abdominal pain
Having a difficult time walking and standing
Having a difficult time peeing
10.
11. Management
Current per-hospital guidance for all suspected pelvic
injuries is the early application of a pelvic splint.
‘’ if the casualty is haemodynamically
compromised with a significant mechanism
suggestive of a pelvic injury, a pelvic binder
should be applied’’
NB: Positioning is key and avoid unnecessary movement
of the casualty, it may cause more injury and bleeding.
12. Method of applying a splint
Not too high otherwise will
open up fracture, should be
over greater trochanters
13. If casualty is haemodynamically
unstable and he/she is bleeding
Direct pressure: expose and firm
pressure
Direct pressure: second dressing,
don’t be tempted to have a look
Indirect Pressure: proximal artery
compression
Tourniquet: Tighten until bleeding
stops (hurts!), may need 2, only
for limbs! Remember to record
time and check.
14. Summary
Where a high suspicion of pelvic injury exists, a pelvic
splint should be apply quickly
If the lower limbs can be placed into normal
alignments the ankles should be stabilized
The pelvic splint should be centered over the greater
trochanters
Casualty movement should be limited; a scoop
stretcher should be used
Airway management will still take priority
For prolong care (>24hrs), consider briefly releasing
the pelvic splint to prevent tissue damage
