Diferencia entre revisiones de «Open book pelvic fracture»
Sin resumen de edición |
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* Unstable pelvis | * Unstable pelvis | ||
* hypotension if large amounts of bleed | * hypotension if large amounts of bleed | ||
* Consider concomitant GU injury | |||
==Diagnosis== | ==Diagnosis== | ||
| Línea 16: | Línea 17: | ||
* If suspect pelvic injury and patient is unstable, place pelvic binder immediately then obtain X-ray when patient is stable. If no pelvic binder is available can use bed sheet wrapped around pelvis of patient | * If suspect pelvic injury and patient is unstable, place pelvic binder immediately then obtain X-ray when patient is stable. If no pelvic binder is available can use bed sheet wrapped around pelvis of patient | ||
- if patient persistently hypotensive even after binder and suspect pelvic artery bleed consider IR for embolization | |||
* Long term management requires orthopedic consultation | * Long term management requires orthopedic consultation | ||
==Complications== | ==Complications== | ||
| Línea 30: | Línea 26: | ||
* Loss of function | * Loss of function | ||
* Genitourinary injury | * Genitourinary injury | ||
==Disposition== | |||
Admission | |||
Revisión del 21:52 9 sep 2015
Background
Open book fracture of the pelvis is a pelvic fracture that results from an anteroposterior compression injury to the pelvis. Often seen in elderly falls vs MVA or other high speed trauma. This causes disruption of pubic symphysis and the pelvis opens like a book, This injury results in tears of the strong pelvic ligaments that hold the pelvis bones together. Large arteries pass near these ligaments and can get torn resulting in massive blood loss.
Clinical Features
- pelvic/Hip pain
- Unstable pelvis
- hypotension if large amounts of bleed
- Consider concomitant GU injury
Diagnosis
- Unstable pelvis on exam
- Xr pelvis in acute trauma setting
- CT Pelvis
Treatment
- In acute setting, stabilize fracture with pelvic binder or bed sheet wrapped around greater trochanter (physician's often make mistake of wrapping around the iliac crest(
- If suspect pelvic injury and patient is unstable, place pelvic binder immediately then obtain X-ray when patient is stable. If no pelvic binder is available can use bed sheet wrapped around pelvis of patient
- if patient persistently hypotensive even after binder and suspect pelvic artery bleed consider IR for embolization
- Long term management requires orthopedic consultation
Complications
- Hypotension from exsanguination
- infection
- Loss of function
- Genitourinary injury
Disposition
Admission