TY  - CHAP
M1  - Book, Section
TI  - Pelvis
A1  - Nassar, Aussama
A1  - Knowlton, Lisa
A1  - Spain, David A.
A2  - Feliciano, David V.
A2  - Mattox, Kenneth L.
A2  - Moore, Ernest E.
PY  - 2020
T2  - Trauma, 9e
AB  - KEY  POINTSThe  anterior  elements  of  the  pelvis,  including  the  pubic  rami  and  pubic  symphysis,  only  contribute  to  approximately  40%  of  pelvic  stability.In  the  Tile  classification  of  pelvic  fractures,  type  A  are  stable,  type  B  are  vertically  stable  but  rotationally  unstable,  and  type  C  are  vertically  and  rotationally  unstable.In  the  Young-Burgess  classification  of  pelvic  fractures,  the  three  types  are  anteroposterior  compression  (APC),  lateral  compression,  and  vertical  shear.Pelvic  binders  are  indicated  for  APC  (“open  book”)  fractures  when  first  diagnosed,  but  not  for  lateral  compression  fractures.Early  external  fixation  stabilizes  the  fractured  elements,  decreases  the  pelvic  volume,  and  allows  clot  to  form.For  the  patient  who  is  exsanguinating  from  a  closed  pelvic  fracture,  embolization  of  the  bilateral  internal  iliac  arteries  is  considered  to  be  the  “damage  control”  procedure  of  choice.In  the  technique  of  preperitoneal  pelvic  packing  for  hemorrhage,  three  laparotomy  pads  are  placed  on  either  side  of  the  bladder  in  the  retroperitoneum.APC  III,  most  lateral  compression  II,  and  vertical  shear  pelvic  fractures  typically  require  posterior  stabilization  by  internal  fixation.The  mean  Injury  Severity  Score  (ISS)  for  patients  with  pelvic  fractures  is  18,  reflecting  the  significant  number  of  patients  with  associated  injuries  to  the  brain,  thorax,  abdomen,  and  long  bones.Control  of  bleeding  in  open  pelvic  fractures  includes  packing  through  the  laceration,  application  of  a  pelvic  binder,  angiographic  embolization,  and  definitive  bony  fixation.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1175138940
ER  -