第75 章 骨盆及髋臼骨折Fractures of Pelvis and AcetabulumXXXFractures of Pelvis Pelvic pathology:Undisplaced/minmally displaced/displaced:Stable fracturePartially stable fracture (rotational)Completely unstable (rotational and vertically/translationally)Isolated iliac wing fracturesUndisplaced pubic ramii fracturesTransverse fractures of sacrum below pelvic ringOs coccygis fracturesAll pelvic ligaments intact!Unstable pelvic fractures:Partially stable:Rotationally unstable:External/internal rotation (lateral compression)Flexion/extensionAbduction/adductionCompletely unstable:Rotationally and vertically (translationally) unstablePartially stable pelvic fractures:Rotationally unstable:Open book fractures > external rotationLateral compression fractures > internal rotationExternal rotation:Mechanisms of injury:Posterior crushDirect pressure ASISExternal rotation through femur(s)> Rupture symphysis/sacrospinous lig./anterior sacroiliac ligAlways posterior and interosses sacroiliac ligaments intact!External rotationally unstable fracture:Partially stable pelvic fractures:Disruption of symphysis only:> Slight external rotation> Widening of symphysis max. 2.5 cm= Open book injuryExternal rotationally unstable fractures:Partially stable pelvic fracture:Disruption of symphysis, sacrospinous ligament andanterior sacroiliac ligament:> Open book injuryMassive external rotation > PSIS abuts sacrum:External rotational instabilityExternal rotationally unstable fractures:Partially stable pelvic fracture:Disruption of symphysis, sacrospinous ligament, all sacroiliac ligaments:> Open book injury with:Massive external rotationFlexion> Transition to vertical/translational instabilityInternal rotation:Mechanisms of injury:Direct pressure to iliac crestForce against greater trochanter > femoral head > acetab...
