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Average 4. Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine. Just skip this one for now. What is the Young-Burgess classification of this injury and the most appropriate treatment plan? Review Topic Tested Concept. He is hemodynamically unstable at initial evaluation in the trauma bay. Advanced Trauma Life Support protocols are started, and an initial survey is completed. A chest radiograph and a pelvis AP radiograph Figure A are obtained.
What is the most appropriate next step? The patient should be taken directly to the OR for percutaneous placement of a pelvic external fixator. Dedicated inlet and outlet views of the pelvis to better classify the fracture. Immediate application of pelvic binder, continued resuscitation and re-evaluation of hemodynamic status. Which of the following is the most common cause of death with this type of pelvic injury pattern?
At a one year follow-up, the only long term sequela of his injuries is erectile dysfunction. Which radiographic injury seen in Figures A-E is most commonly associated with this complication? In the emergency room he is alert and oriented and is hemodynamically stable.
On physical exam he is unable to bear weight on his left lower extremity. There is no tenderness to palpation at the posterior pelvis. A radiograph is performed and shown in Figure A and CT examination shows the posterior ring is stable and age-appropriate. What is the most appropriate treatment for this injury pattern? During fluoroscopic-aided fixation, a lateral sacral view is used for proper placement of which of the following fixation methods?
Which of the following best describes the radiographic findings associated with this pelvic injury pattern using the Young-Burgess Classification system? Widened anterior SI joint, disrupted sacrotuberous and sacrospinous ligaments with intact posterior SI ligaments. Sacral compression fracture on side of impact with transverse pubic rami fractures. Pubic symphysis diastasis, intact anterior sacroiliac ligaments, intact sacrotuberous ligament, intact posterior sacroiliac ligaments. Pubic symphysis diastasis, torn anterior sacroiliac ligaments, intact sacrotuberous ligament intact posterior sacroiliac ligaments.
Pubic symphysis diastasis, intact anterior sacroiliac ligaments, torn sacrotuberous ligament, intact posterior sacroiliac ligaments.
Pubic symphysis diastasis, torn anterior sacroiliac ligaments, torn sacrotuberous ligament, intact posterior sacroiliac ligaments. Pubic symphysis diastasis, intact anterior sacroiliac ligaments, torn sacrotuberous ligament, torn posterior sacroiliac ligaments. Which of the following imaging techniques best describes the correct utilization of intraoperative flouroscopy for percutaneous iliosacral screw placement across S1? She subsequently undergoes reduction and percutaneous bilateral iliosacral screw placement.
Which of the following is the most likely neurologic complication associated with percutaneous iliosacral screw insertion? He is intubated in the field and receives 2 liters of LR and continues to be tachycardic and hypotensive. A massive transfusion protocol is initiated.
Which of the following is true regarding the transfusion of packed red blood cells, platelets, and fresh frozen plasma? A chest radiograph shows a left-sided hemothorax and her pelvis radiograph is shown in Figure A. Which of the following is the next most appropriate step in managment? A pelvis radiograph is shown in Figure A.
He is placed in a pelvic binder, and his blood pressure normalizes temporarily. An abdominal CT demonstrates free fluid and air in the intraperitoneal cavity, and a laparotomy is indicated. What is the most appropriate next step in orthopaedic management?
She sustained isolated orthopedic injuries noted in Figures A-C. The mortality rate for this patient approaches: Review Topic Tested Concept. Which of the following fixation methods has been shown to be the most stable fixation construct for this injury? What is the most common urological injury associated with this injury pattern? She was placed in a cervical collar and intubated at the scene. She has obvious open fractures of the right forearm and left ankle.
On exam, the lower extremities are externally rotated and the pubic symphysis is widened and unstable. Intravenous access is obtained and radiographs are pending. What is the most urgent next step in management? She is hemodynamically unstable and undergoes emergent pelvic supra-acetabular external fixation followed by laparotomy. She is now hemodynamically stable and cleared for surgery. She has no evidence of neurologic deficit on examination. Which of the following factors is a relative contraindication to open reduction and plating of her posterior pelvic injury from an anterior approach?
Two weeks after delivery she reports anterior pelvic pain and a radiograph is obtained Figure A. What is the next step in management? What structure should be reduced and stabilized first?
He is otherwise hemodynamically stable. A radiograph is shown in Figure A. A stress examination under anesthesia does not show any further anterior diastasis or posterior pelvic ring displacement. Computed tomography reveals no asymmetry of the sacroiliac joints. What is the most appropriate management of this injury?
Pelvic Ring Fractures. Brian Weatherford. Please rate topic. Please vote below and help us build the most advanced adaptive learning platform in medicine The complexity of this topic is appropriate for? L2 - PGY3. L3 - PGY4. L4 - PGY5. L5 - Fellow. L6 - years in practice. L7 - years in practice. L8 - 10 years in practice. How important is this topic for board examinations? How important is this topic for clinical practice? No, Thanks Submit. Upgrade to PEAK.
Take This Question Anyway. L 3 Question Complexity. Question Importance. L 1 Question Complexity. L 2 Question Complexity. L 4 Question Complexity. Sort by. All Videos 4 Podcasts 2. Upgrade to View Premium Videos. Login to View Community Videos. Gaurav Sanjay. Orthobullets Team. Listen Now min. Pelvic Ring Injury in 25M C Robert Wessel.
Pelvis fracture and left femure fracture C Bahadar Khan. Please login to add comment. Cancel Save. APC I. APC II.
It comprises of two ipsilateral pelvic ring fractures , which are vertically oriented:. Most commonly there is disruption of the ipsilateral superior and inferior pubic rami and sacroiliac joint. Common variants involve the ilium or sacral wing rather than the sacroiliac joint. This results in an unstable lateral fragment, which contains the acetabulum.
Pelvic Ring Fractures