骨盆及髋臼骨折王满宜

《骨盆及髋臼骨折王满宜》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、骨盆及髋臼骨折FracturesofPelvisandAcetabulum王满宜北京积水潭医院FracturesofPelvisPelvicpathology:Undisplaced/minmallydisplaced/displaced:StablefracturePartiallystablefracture(rotational)Completelyunstable(rotationalandvertically/translationally)IsolatediliacwingfracturesUndisplacedpubicramiifracturesTransver

2、sefracturesofsacrumbelowpelvicringOscoccygisfracturesAllpelvicligamentsintact!Unstablepelvicfractures:Partiallystable:Rotationallyunstable:External/internalrotation(lateralcompression)Flexion/extensionAbduction/adductionCompletelyunstable:Rotationallyandvertically(translationally)unstablePar

3、tiallystablepelvicfractures:Rotationallyunstable:Openbookfractures>externalrotationLateralcompressionfractures>internalrotationExternalrotation:Mechanismsofinjury:PosteriorcrushDirectpressureASISExternalrotationthroughfemur(s)>Rupturesymphysis/sacrospinouslig./anteriorsacroiliacligAlwayspost

4、eriorandinterossessacroiliacligamentsintact!Externalrotationallyunstablefracture:Partiallystablepelvicfractures:Disruptionofsymphysisonly:>Slightexternalrotation>Wideningofsymphysismax.2.5cm=OpenbookinjuryExternalrotationallyunstablefractures:Partiallystablepelvicfracture:Disruptionofsymphys

5、is,sacrospinousligamentandanteriorsacroiliacligament:>OpenbookinjuryMassiveexternalrotation>PSISabutssacrum:ExternalrotationalinstabilityExternalrotationallyunstablefractures:Partiallystablepelvicfracture:Disruptionofsymphysis,sacrospinousligament,allsacroiliacligaments:>Openbookinjurywith:M

6、assiveexternalrotationFlexion>Transitiontovertical/translationalinstabilityInternalrotation:Mechanismsofinjury:DirectpressuretoiliaccrestForceagainstgreatertrochanter>femoralhead>acetabulumForceparalleltosacralplanethroughSI.joint(s)Internalrotationallyunstablefractures:Partiallystablepelvic

7、fracture:CrushoflateralsacrumDisruptionofposteriorsacroiliacligamentAlwaysanteriorlesion:TranssymphysealTranspubic>LateralcompressioninjuryAlwayspelvicfloorintact!Verticalshear:Mechanismsofinjury:Forceperpendicularto:SacralplaneSI-jointplane(s)Rota