Presentation
High-speed motor vehicle accident.
Patient Data
Age: 25 years
Gender: Female
From the case:
Bilateral acetabular fractures
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There is a comminuted medially-displaced fracture of the left acetabulum with medial migration of the left femoral head. There is also disruption of the right sacral ala with minimal displacement. Pelvic binder noted.
From the case:
Bilateral acetabular fractures
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Multiple injuries of the pelvis:
- Left comminuted displaced acetabular and ischial tuberosity fractures - Judet Letournel complex type, both columns. Posterior subluxation of the femoral head and joint effusion. Associated left pelvic sidewall hematoma. No vascular blush.
- Right undisplaced acetabular fracture - Judet Letournel simple type, anterior wall. The quadrilateral plate is intact.
- Comminuted sacral fractures - bilateral Denis zone 2 and 3, right zone 1. Associated presacral extraperitoneal fluid with a maximum thickness of 13mm.
- Widened left sacroiliac joint. Mild asymmetry of the pubic symphysis. Non displaced right inferior pubic ramus fracture. AP compression type pelvic injury.
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IDC in situ. Extensive left pelvic plate and screws as well as right SI joint screw. The left acetabulum shows minimally displaced fractures with left femoral head anatomically aligned.
Case Discussion
Complex pelvis fractures can be subcategorised into different components, in this case with sacral, acetabular and pelvic ring injuries.
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