3. Pelvic Ring Injuries
An unstable pelvic injury may
allow hemorrhage to collect in
the true pelvis as there is no
longer a constraint which
allows tamponade.
Best estimated by a hemi-elliptical sphere
(Stover et al, J Trauma, 2006)
4. Hemorrhage Control:
Methods
• Closed reduction of pelvis at
admission.
• External fixation.
• Control of haemorrhage.
• Pelvic packing.
• Angiography.
• Control of contamination.
• Repair of genitourinary and rectal
injuries.
• Debridement of necrotic tissue in
case of open injury.
14. Technical Details: ASIS
frames…
• Fluoroscopy dependent
• 3 to 5 cm posterior to the ASIS
• Along the gluteus medius pillar
• Pin entry at the junction of the lateral
2/3 and medial 1/3 of the iliac crest
• Aim: 30 to 45 degrees (from lateral to
medial)
• Towards hip joint, convergent pins.
24. Anti-shock Clamp (C-clamp)
The insertion points for the pins lie on the crossing
point of the femoral shaft axis and on a vertical line
starting just caudal to the anterior superior illiac
spine.
As we are aware of the fact pelvic fractures being high energy trauma and results in high morbidity and mortality.
External fixation being done after provisonal stabilistaion with binders and sheets, and to be followed by external fixation allowing temporary stabilization and allowing acces to abdomen and perineum.
Routinely being done ,
Ideally 5 mm pin
Usually 2 pins but one can use 3 pins in the illiac wing for accurate pin placment.
Palpate the illiac wing 2-4 cm proximally to ASIS.
Longitudunal incison is made .
Guide wire plavced along the inner table.
Lateral entry point may exit the pelvis.
Converging pins to be used and directing towards the hip joint.
