HISTORY A 30 yr Male brought to EM on Stretcher CO pain in pubic region Ho MVA Previous conservative treatment taken Unable to sit ON EXAMINATION GE WNL ON Ex Tenderness over pubic and low back region ID: 935888
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Slide1
Dr. Amol Patil
A CASE OF NEGLECTED PELVIS FRACTURE
Slide2HISTORY
A 30 yr Male brought to EM on Stretcher.
C/O pain in pubic region.
H/o MVA.
Previous conservative treatment taken.
Unable to sit.
Slide3ON EXAMINATION
G/E- WNL.
ON Ex- Tenderness over pubic and low back region.
Pelvic Distraction/compression tests +
Pelvic
symphysis
gap of 3 finger breadth present.
No DNVC.
Rt
lower limb shortening of 2cm.
Slide4RADIOLOGICAL EVALUATION
Slide5PELVIS WITH BOTH HIP AP VIEW
Slide6X RAY S/O
Unstable Pelvic Ring
Diastasis
USG-
Abdo
-pelvis (WNL)
CT Scan
.
Slide7C T SCAN
Slide8CT Scan Axial cut
Slide932 mm
Slide10DIAGNOSIS
Pelvis
symphyseal
diastasis
– (APC) Antero-posterior compression type II Unstable fracture according to YOUNG AND BURGESS classification.
Slide11CHALLENGES DECIDING THE MANAGEMENT
Pre Operatively
Bed Ridden patient.
Anatomical variation.
Slide12COPYRIGHTS @ GRAYS ANATOMY
Slide13COPYRIGHT @ROCKWWOD & GREENS FRACTURES IN ADULTS VOLUME 2
Slide14TREATMENT
Pubic
Diastasis
– ORIF with plating.
SI joint – CRIF with CC screw Fixation.
Intra op
-Reduction and deformity correction.
-
Neuro
vascular damage.
Slide15INTRA OP IMAGES
Slide16Slide17Slide18Slide19Slide20Slide21POST OPX RAY – PELVIS
Slide22Slide23POST OP MANAGEMENT
Prpoed
up position till 45
degree
for 2 weeks.
Weight bearing walking after 4 weeks.
Check x ray after 4 weeks.
Slide24Take Home Message
If managed properly, Pelvic injuries can be
treated
without extensive approaches.