12/9/2023 0 Comments Bone fracture pelvic![]() ![]() 11 In particular, female patients over 80 years sustain pelvic ring injuries, with low-energy impact as the main cause of these injuries. 9, 10 However, a Swedish study in the early 1990s showed that the incidence of pelvic ring fractures notably increases in geriatric patients. 5Ībout 3% of all fractures affect the pelvic ring. A more exact classification is the CCF-classification (Comprehensive Classification of Fractures) which uses different qualificators to describe the respective lesions more exactly. Consequently, Type A injuries are considered as stable, while Type B and C injuries are considered as unstable fractures. 1b), in Type C injuries the posterior pelvic ring is disrupted completely ( Fig. ![]() While in Type B injuries the posterior pelvic ring fracture is incomplete ( Fig. The difference between Type B and Type C injuries lies in the posterior lesion. 1a), isolated lesions of the posterior ring or combined anterior and posterior pelvic ring fractures are classified as Type B or Type C injuries. Whilst isolated lesions of the anterior pelvic ring are classified as Type A injuries ( Fig. For proper classification, a CT scan is necessary. The most widely used system is the AO-classification which is based on the affected part of the pelvic ring and gives information regarding the stability of the pelvic ring ( Fig. There are different classification systems for pelvic ring fractures. This is the typical mechanism of the lateral compression injury. 2 While the muscle forces are distributed evenly during normal walking, the superior pubic rami are especially stressed when there is strong pressure from the side. 6īiomechanically, the pelvic ring and especially the superior pubic rami direct the muscle forces during upright walking dorsally towards the SI joints and via the symphysis towards the opposite side. Therefore, the pelvic ring plays a crucial role in the stabilization of the trunk as well as the mobility of the hip joints. Laterally, the superior pubic rami pass into the anterior columns of the acetabula, and the inferior pubic rami act as a bridge between the pubic and the ischial bones.įunctionally, the pelvic ring serves as a border for the intrapelvic organs on one hand and is the insertion point of the gluteal hamstrings, the abdominal muscles and the pelvic floor muscles on the other hand. Beginning at the symphysis it divides into two branches, the superior and inferior pubic rami. The anterior pelvic ring mainly consists of the pubic bone. Between the anterior and the posterior parts of the pelvic ring, the two acetabula are located within the iliopectineal lines and the quadrilateral plates, which function as a bony connection between the anterior and the posterior pelvic ring. The anterior part reaches from the anterior columns of the acetabula along the pubic rami to the symphysis. 5 The posterior pelvic ring is defined as the part between the two SI joints including the two SI joints and the sacral bone. In the orthopaedic trauma context, the pelvic ring is divided into a posterior and an anterior part. While the symphysis is composed of a combination of hyaline and fibrous cartilage, 1 the SI joints mainly consist of fibrous cartilage combined with a strong joint capsule and strong ligaments. The pelvic ring consists of the sacrum and the two hip bones (each one of them consisting of an ischium, ilium and pubic bone) which are connected by three joints, namely two sacroiliac (SI) joints between the sacral bone and the iliac wings, and the symphysis, which connects the two pubic rami. Anatomy and biomechanics of the pelvic ring
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