14. SOFT TISSUES
1.GLUTEUS MINIMUS FAT STRIPE
BULGING OF THIS PAD MAY INDICATE
PRESENCE OF EFFUSION IN HIP JOINT
2.ILIOPSOAS
BULGING OF THIS PAD MAY INDICATE
PRESENCE OF EFFUSION IN HIP JOINT
3.OBTURATOR FAT STRIP
DISPLACEMENT OR BULGING MAY
INDICATE PELVIC SIDEWALL HEMATOMA
SECONDARY TO A FRACTURE
16. 1.x Ray beam angled
~ 45-degree cauda
2. Adequate image when S1
overlaps S2
IDEAL FOR:
1. Anterior or posterior
translation of hemipelvis
2. Internal or external
rotation of the
hemipelvis
3. Widening of SI joint
4. Sacral ala impaction.
17. 1.X RAY beam is
angled 45 degree
cephalad
2. Adequate image
when pubic
symphysis overlies
S2 body.
IDEAL FOR:
1.Vertical
translation of the
hemipelvis
2.Flexion/
extension of the
hemipelvis
3.Disruption of
sacral foramina
and location of
sacral fractures
18. Four main forces have been described in high-energy blunt force trauma
that results in unstable pelvic fractures :
1. Anteroposterior compression: result in an open book or sprung
pelvis fractures
2.Lateral compression: result in a windswept pelvis
3.Vertical shear: results in Malgaigne fracture or bucket handle fracture
4.Combined mechanical: occur when two different force vectors are
involved and results in a complex fracture pattern
19.
20. LATERAL COMPRESSION TYPE I LATERAL COMPRESSION TYPE II LATERAL COMPRESSION TYPE III
1. Pubic ramus fracture 1. Pubic ramus fracture 1. Bilateral pubic ramus fracture
2. Sacral crush injury 2. Posterior iliac wing fracture
extending into SI joint
2. Posterior iliac wing fracture
extending into SI joint
3. SI joint widening and disruption of
posterior SI ligaments.
3.Contralateral SI joint widening and
disruption of sacrotuberous and
sacrospinous ligaments.
21. AP COMPRESSION TYPE I AP COMPRESSION TYPE II AP COMPRESSION TYPE III
1.Pubic symphysis diastasis <2.5 cm 1.Pubic symphysis diastasis > 2.5cm 1.Pubic symphysis diastasis > 5 cm
2. Opening of anterior ring 2. Opening of anterior ring
2.Anterior SI ligaments intact 3. Anterior SI ligaments disrupted 3.Anterior SI ligaments disrupted
4. Disruption of sacrotuberous and
sacrospinous ligaments
4. Disruption of sacrotuberous and
sacrospinous ligaments
3. Mild widening of SI joint. 5.Widening of the ipsilateral SI joint 5. Complete dissociation of the
ipsilateral SI joint.
6. Posterior SI ligaments intact 6. Posterior SI ligaments disrupted.
26. 1.Bilateral superior and
right-sided inferior
pubic rami fractures
(black arrows)
2. A subtle disruption of
a right sacral arcuate
line (white arrow).
28. 1.Fractures of the bilateral
superior and inferior pubic
rami (white arrows)
2.compression fracture
through the left sacrum
(black arrow),
3.Gross widening of the
contralateral right SI joint
(arrowhead) with external
rotation of the right iliac
wing is also seen, findings
indicative of a “wind- swept
pelvis” injury.
29. AP radiograph of the pelvis
shows pubic symphysis
1. diastasis of 1.5 cm
2. no apparent posterior
pelvic ring injury, findings
consistent with an AP
compression type 1 injury.
30. 1.pubic symphysis diastasis
2.significant widening of the
right SI joint (white arrow)
3.slight posterior
displacement of the right iliac
side of the SI joint suggests
posterior ring ligamentous
disruption
4. Mild widening of the left SI
joint is also seen
31. AP radiograph of the pelvis
shows
1.widening of the pubic
symphysis (white arrow),
2. left and right (black arrow)
sacral fractures.
3.fracture of the transverse L5
process (arrowhead)
