Windswept pelvis with internal fixation
Updates to Case Attributes
This pelvic ring fracture is predominantly an open book type (AP compression), but the right sacral fracture seen on CT shows the there were more complex mechanical forceswas a lateral mechanical force also involved in the injury. The combination of the unilateral AP compression injury with a contralateral lateral compression injury is the definition of a "windswept pelvis", although the lateral compression injury component in this case is subtle.
Pelvic ring fractures are unstable injuries and internal fixation is warranted.
-<p>This <a title="Pelvic fracture" href="/articles/pelvic-fractures">pelvic ring fracture</a> is predominantly an <a title="Open book fracture" href="/articles/open-book-fracture">open book</a> type (AP compression), but the right sacral fracture seen on CT shows the there were more complex mechanical forces involved in the injury.</p><p>Pelvic ring fractures are unstable injuries and internal fixation is warranted.</p>- +<p>This <a href="/articles/pelvic-fractures">pelvic ring fracture</a> is predominantly an <a href="/articles/open-book-fracture">open book</a> type (AP compression), but the right sacral fracture seen on CT shows there was a lateral mechanical force also involved in the injury. The combination of the unilateral AP compression injury with a contralateral lateral compression injury is the definition of a "<a href="/articles/windswept-pelvis">windswept pelvis</a>", although the lateral compression injury component in this case is subtle.</p><p>Pelvic ring fractures are unstable injuries and internal fixation is warranted.</p>
Updates to Study Attributes
The radiograph is underpenetrated, but one can still seen wideningsee widening of the symphysis pubis and of the left sacroiliac joint. This is compatible with a pelvic ring injury and CT of the pelvis is the next step to look for any other fractures that may not be visible on the radiograph. The CT revealed an additional right sacral fracture, difficult or impossible to see on the radiograph.
The CT is also useful to look for pelvic visceral or arterial injury (e.g. the left superior gluteal artery).
Updates to Study Attributes
Post open reduction and internal fixation of the pelvic ring fractures:
- supra-acetabular pedicle screws are connected anteriorly with
an anterior spinala spinal rod - cannulated screws through the sacroiliac joints fuse the posterior pelvis
Image X-ray (Frontal) ( update )
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