Pelvic Fractures: NEET PG Essentials
1. Classification (Young-Burgess)
The Young-Burgess classification is based on the mechanism of injury:
- APC (Anteroposterior Compression): “Open book” injury; rotationally and potentially vertically unstable.
- LC (Lateral Compression): Most common type; rotationally unstable but often stable vertically.
- VS (Vertical Shear): Highly unstable (rotationally and vertically).
2. High-Yield Clinical Associations
| Feature | High-Yield Detail |
|---|---|
| Hemorrhage | The primary cause of death. Venous plexus bleeding is more common than arterial bleeding. |
| Urethral Injury | Suspect if blood is at the meatus or high-riding prostate. Retrograde urethrogram is the diagnostic test of choice. |
| Pelvic Binder | Immediate application at the level of the greater trochanters to reduce pelvic volume and control hemorrhage. |
3. Examination Pearls
- Stability Testing: Avoid repeated, vigorous testing of pelvic stability as it can disrupt formed clots and worsen hemorrhage.
- Acetabular Fractures: Use the Judet views (obturator oblique and iliac oblique) to define the specific column/wall involvement.
- Tile Classification: Another common system focusing on stability: Type A (stable), Type B (rotationally unstable), Type C (rotationally and vertically unstable).
- Angiography: Indicated for patients with persistent hemodynamic instability despite pelvic stabilization, to identify and embolize arterial bleeding sources.