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Pelvic fractures
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
Patients with high energy pelvic ring disruptions are commonly described using two radiological classification systems: the AO/OTA classification mainly devised by Tile29,30 and the Young-Burgess classification developed in Baltimore.31 The Tile/OTA32 system is a morphological system based on pelvic ring stability and in particular the integrity of the posterior ligament complex. Injuries are divided into stable (type A), rotationally unstable (type B) and vertically unstable patterns. The rotationally unstable types are classified as open book patterns (B1), lateral compression (B2) or combinations of these two patterns (B3). Vertical shear patterns are either unilateral (C1), combined with contralateral rotational injury (C2) or bilateral vertical shear (C3). This is the most comprehensive classification system with the ability to describe most patterns of injury in detail with the use of subgroups under each main category.
Emergency Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Alastair Brookes, Yiu-Che Chan, Rebecca Fish, Fung Joon Foo, Aisling Hogan, Thomas Konig, Aoife Lowery, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Colin Walsh, John Wang, Ting Hway Wong
What pelvic fracture classification systems do you know?The Young−Burgess classification system is based on mechanism of injury: anteroposterior compression (APC) type I, II and III, lateral compression (LC) types I, II and III, and vertical shear (VS).LC I and APC I are mechanically stable (only one break point); the remainder are mechanically unstable.Another classification in use is the Tile classification, based on pelvic stability.A more recent definition includes the haemodynamic status, in addition to the anatomical classification of the Young−Burgess:Combing the ATLS definition of ‘unstable’ patients (systolic blood pressure <90 mmHg, heart rate >120 bpm, evidence of skin vasoconstriction (cool, clammy, decreased capillary refill), altered level of consciousness and/or shortness of breath) with the Young−Burgess anatomical classification, the WSES Classification divides Pelvic ring Injuries into three classes: Minor (WSES grade I) comprising haemodynamically and mechanically stable lesionsModerate (WSES grade II, III) comprising haemodynamically stable and mechanically unstable lesionsSevere (WSES grade IV) comprising haemodynamically unstable lesions independently from mechanical status.
Lower urinary tract injuries in patients with pelvic fractures at a level 1 trauma center – an 11-year experience
Published in Scandinavian Journal of Urology, 2023
Lasse Rehné Jensen, Andreas Røder, Emma Possfelt-Møller, Upender Martin Singh, Mikael Aagaard, Allan Evald Nielsen, Lars Bo Svendsen, Luit Penninga
All trauma patients admitted (primary or secondary) to the Trauma Centre, Rigshospitalet, Copenhagen University Hospital, from 1 January 2009 to 31 December 2020 were included. The Trauma Center covers a population of 2.7 million people. Traumatic pelvic, acetabular and urological surgery is centralized to Rigshospitalet. Patients with pelvic and acetabular fractures were identified in our prospective Trauma Registry. Patient charts were manually reviewed for concomitant urological trauma. The following variables were extracted: age, sex, date of trauma, trauma mechanism, date of urological injury, diagnostic, date of surgery, fracture characteristics, and ISS. An experienced orthopedic trauma surgeon classified pelvic fractures according to Young-Burgess classification system: Anteroposterior compression (APC) I–III, Lateral compression (LC) I–III, Vertical shear (VS), or Combined fractures.