pelvic and femoral fx

Question 1

why are pelvic fx imp?

Answer 1

cause hemorrhagic shock in trauma pts, urethral and bladder injuries

Question 2

describe 3 types of pelvic fx

Answer 2

-open book: widening of pubic symphysis (diastasis). sacroiliac joint disruption and urethral injuries

-wind-swept fx: internal rotation of one hemipelvis and external rotation of contralateral hemipelvis and diastasis of contralateral sacroiliac joint. can have open book fx

-bucket handle fx: sacroiliac joint disruption and ipsilateral fx of pubic ramus

Question 3

management of pelvic fx?

Answer 3

resuscitate pt with trauma protocol, give IV fluids as needed

-apply pelvic binder and external fixator in unstable pts until definitive management

-definitive: machanically stable fx tx is conservative with limitation of weight bearing.

is unstable like pubic diastasis more than 2.5cm, IS displacement more than 1cm, hemipelvis displacement, do ORIF

Question 4

complications of femoral shaft fx

Answer 4

shock, neurovascular injury, fat emboli, ipsilateral hip dislocation

Question 5

femoral shaft fx management?

Answer 5

if hemodynamically unstable, resuscitate following trauma protocol ABCDE

-if open, give ABs and tetanus booster and analgesics, wound debridement

-for initial management, use external fixation (if open/unstable pt) until definitive tx with ORIF