Abstract
A jockey sustains lower torsopelvic trauma after his horse falls on him while attempting to jump over a hurdle. The patient presents with an obvious crushed pelvis. The patient is hemodynamically stable. A retrograde urethrogram was performed (no urethral injury) followed by cystography that demonstrated an extraperitoneal bladder injury. Further diagnostic evaluation (computed tomography scan) demonstrated no abdominal pathology. The unstable pelvis fracture will require the application of an external fixator.Which of the following is an essential component of this specific management plan?
-
(A)
Diagnostic peritoneal lavage
-
(B)
Laparoscopy
-
(C)
Diverting colostomy
-
(D)
Pelvic angiography
-
(E)
Proctoscopy
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Vrahas M, Hearn TC, Diangelo D, Kellam J, Tile M. Ligamentous contributors to pelvis stability. Orthopedics 1995; 18:271–274.
Tile M, Hearn T. Biomechanics. In Tile M, ed. Fractures of the Pelvis and Acetabulum, 2nd ed. Baltimore: Williams & Wilkins, 1995; 22–36.
Tile M. Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br 1988; 70:1–12.
Tile M. Classification. In Tile M, ed. Fractures of the Pelvis and Acetabulum, 2nd ed. Baltimore: Williams & Wilkins, 1995; 66–101.
Tile M. Acute pelvic fractures I: causation and classification. J Am Acad Orthop Surg 1996; 4:143–151.
Tile M. Acute pelvic fractures II: principles of management. J Am Acad Orthop Surg 1996; 4:152–161.
Young JW, Burgess AR, Brumback RJ, et al. Pelvic fractures: value of plain radiography in early assessment and management. Radiology 1986; 160:445–451.
Gansslen A, Pohlemann T, Paul CH, et al. Epidemiology of pelvic ring injuries. Injury 1996; 27(Suppl 1):S-A13-20.
McMurtry RY, Walton D, Dickinson D, et al. Pelvic disruption in the polytraumatized patient. A management protocol. Clin Orthop 1980; 151:22–30.
Slatis P, Huittinen VM. Double vertical fractures of the pelvis: a report on 163 patients. Acta Chir Scand 1972; 138:799–807.
Colapinto V. Trauma to the pelvis: urethral injury. Clin Orthop 1980; 151:46–55.
Dalal S, Burgess AR, Siegel J, et al. Pelvic fracture in multiple trauma: classification by mechanism is key to pattern of organ injury, resuscitative requirements, and outcome. J Trauma 1989; 29:1000–1002.
Agolini SF, Shah K, Jaffe J, et al. Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage. J Trauma 1997; 43:395–399.
Bottlang M, Simpson T, Sigg J, et al. Noninvasive reduction of open-book pelvic fractures by circumferential compression. J Orthop Trauma 2002; 16:367–373.
Falcone RE, Thomas BW. “Bean bag” pelvic stabilization. Ann Emerg Med 1996; 28:458.
Buckle R, Browner BD, Morandi M. A new external fixation device for emergent reduction and stabilization of displaced pelvic fractures associated with massive hemorrhage. J Orthop Trauma 1993; 7:177–178.
Ganz R, Krushell RJ, Jakob RP, et al. The antishock pelvic clamp. Clin Orthop 1991; 267:71–78.
Pohlemann T, Braune C, Gansslen A, et al. The pelvic emergency clamps: anatomic landmarks for a safe primary application. J Orthop Trauma 2004; 18:102–105.
Kellam JF. The role of external fixation in pelvic disruptions. Clin Orthop 1989; 241:66–82.
Riemer BL, Butterfield SL, Diamond DL, et al. Acute mortality associated with injuries to the pelvic ring: the role of early patient mobilization and external fixation. J Trauma 1993; 35:671–677.
Nerlich M, Maghsudi M. Algorithms for early management of pelvic fractures. Injury 1996; 27(Suppl 1):S-A29-37.
Pohlemann T, Bosch U, Gansslen A, et al. The Hannover experience in management of pelvic fractures. Clin Orthop 1994; 305:69–80.
Witschger P, Heini P, Ganz R. Pelvic clamps for controlling shock in posterior pelvic ring injuries: application, biomechanical aspects and initial clinical results. Orthopade 1992; 21:393–399.
Mucha P Jr, Welch TJ. Hemorrhage in pelvic fractures. Surg Clin North Am 1988; 68:757–773.
Weis EB. Subtle neurological injuries in pelvic fractures. J Trauma 1984; 24:983–985.
Geertz WH, Code KI, Jay RM, et al. A prospective study of venous thromboembolism after major trauma. N Engl J Med 1994; 331:1601–1606.
Buerger PM, Peoples JB, Lemmon GW, et al. Risk of pulmonary emboli in patients with pelvic fractures. Am Surg 1993; 59:505–508.
Draijer F, Egbers HJ, Havemann D. Quality of life after pelvic ring injuries: follow-up results of a prospective study. Arch Orthop Trauma Surg 1997; 116:22–26.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Rodner, C.M., Browner, B.D. (2007). Pelvis. In: Britt, L.D., Trunkey, D.D., Feliciano, D.V. (eds) Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69012-4_37
Download citation
DOI: https://doi.org/10.1007/978-0-387-69012-4_37
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-34470-6
Online ISBN: 978-0-387-69012-4
eBook Packages: MedicineMedicine (R0)