What is the Pretzel principle?
- Pelvis is a ring-shaped structure
- Difficult to break in one spot only
- More than 1 fracture in the pelvis, consider it unstable
Tile Classification: Stable
- Iliac wing
- Avulsion
- Transverse sacral
- Ischiopubic rami
Tile Classification: Unstable
- Malgaigne
- Bucket handle
- Straddle
- Vertical sacral
- Sprung
What is a Duverney (Iliac Wing) Fracture?
It is a vertical or oblique break of the iliac wing fragment from the pain of the iliac bone.
Usually caused by direct trauma.
There is separation of the lateral iliac wing fragment.
What should you refer for when a Duverney fracture is present?
Refer for crutches or a walker
What are some complications caused by a Duverney fracture?
- Malunion
- Injury to the iliac artery or bowel perforation
- Other fractures
What is an Avulsion fracture?
It is a fracture due to forceful contractions of attached muscles as seen in soccer or gymnastics.
The secondary ossification centers
[apophyses] are the most likely parts of the bones of the pelvis to
avulse [pull apart].
What muscle is involved in an ASIS avulsion?
Sartorius muscle
What is the treatment for an Avulsion fracture?
- Rest for 6-8 weeks
- Return when all movements are
painless
Describe an avulsion fracture of the ischial tuberosity.
- Hamstring muscles are involved
- Seen commonly in jockeys
What is Rider’s Bone?
Bone formation in the upper part of
the hamstring muscles due to chronic irritation caused by sitting on the saddle during riding.
What is an example of Rider’s Bone?
Myositis Ossificans
What muscle is involved in an AIIS avulsion?
Rectus Femoris muscle
What are the three types of Sacral fractures?
- Stress
- Transverse
- Longitudinal
Describe a stress fracture.
Happens from repetitive injury from high intensity athletic training.
Seen best on CT scan.
Describe a transverse fracture.
Happens from direct injury.
Seen in stable fractures.
Describe a longitudinal fracture.
Usually happens from oblique injury.
Seen in unstable fractures.
What are the two types of Acetabular fracture?
- Posterior Rim
- Central Acetabulum
What is a Posterior Rim Acetabular fracture also known as?
Dashboard fracture
What is the MOI for a Posterior Rim acetabular fracture?
Hip flexion and Abduction
Posterior Rim Acetabular fracture: stable or unstable?
Stable fracture
What is a Posterior Rim Acetabular fracture associated with?
Femoral Dislocation (posterior)
What is a Central Acetabulum fracture also known as?
Acetabular blow-out fracture
What is the MOI of a central Acetabulum fracture?
Side-impact (think T-bone)
