fracture of pelvis and spine
TRANSCRIPT
Fracture pelvis and spine
Pelvic Fractures
• Pelvic fracture is a high energy trauma , as a result of MVA, fall .
• Classifications. ( Tile)
Type A. Stable
A 1. fractures of the pelvic not involving the Ring.
A 2 . Stable , minimally displaced fracture of the Ring .
• Type B. Rotationally Unstable ,Vertically Stable.
B1. Open Book
B2 . Lateral Compression : Ipsilateral
B3. Lateral Compression :Contra lateral
• Type C. Rotationally and Vertically Unstable
C1 . Unilateral
C2 . Bilateral
C3 . Associated with Acetabular Fracture
MANEGEMENT• Aggressive treatment .
• Obtain X-Ray: AP pelvic, Inlet ,outlet ,Ct Scan.
Treatment
• Aggressive treatment . By A.B.C.D.
• Obtain X-Ray: AP pelvic, Inlet ,outlet
• Ct Scan.
• Think in systemic approach.
• Specific treatment:
type A . symptomatic treatment
type B .ORIF with plates& screws ,External Fix.
Type C . ORIF with plates & screws. Both AP.
Acetabular fracture
• Usually it is a result of high- energy trauma .
• The acetabulum is divided into four segments—an anterior column and wall (rim) and a posterior column and wall (rim). . Fractures of the acetabulum are classified based on their involvement of these structures .
classification Letournel and Judet
Fractures of the Spine
Stability of vertebrae is maintained by :
♥ strong ligaments :
- ant. & post. longitudinal lig.
- interspinus ,supraspinus lig.,
and ligamentum flavum
♥ articular facets :
- vertical in D – L vertebrae
- horizontal in Cx vertebrae.
♥ Intervertebral discs.
Types of fracture spine
♥ stable fr. : - wedge fr.
- comminuted fr.
♥ unstable fr. : - fr. dislocation.
Usually caused by :
- hyper flexion injury,
- vertical compression,
- rarely hyper-extension .
Wedge fracture L 2
Complications
♥ in unstable fr.- dislocations, complete trans-sectionof the cord may occur, leading to permanentparaplegia, with its dangerous complications ofprolonged bed recumbency .
♥ PARAPLEGIA ..
due to damage or compression ofthe spinal cord.
Treatment
♥ 1st. aid : patient transferred
with max. care to prevent
cord injury.
♥ Stable fr. : bed rest, then
back support brace.
♥ Unstable fr. : O.R.I.F. + cord
decompression.
Injuries of the cervical spine
♥ pure dislocation may occur
without fracture, due to
horizontal position of
articular facets.
Hyper- extension injury of C2 – C3
( Hanging )