Property of Department of Orthopedic, Faculty of Medicine, University of Zagazig, Egypt

1. Fracture pelvis and spine

2. Pelvic Fractures
• Pelvic fracture is a high energy trauma , as a
result of MVA, fall .
• Classifications. ( Tile)
Type A. Stable
A 1. fractures of the pelvic not involving the
Ring.
A 2 . Stable , minimally displaced fracture of
the Ring .

5. • Type B. Rotationally Unstable ,Vertically
Stable.
B1. Open Book
B2 . Lateral Compression : Ipsilateral
B3. Lateral Compression :Contra lateral

7. • Type C. Rotationally and Vertically Unstable
C1 . Unilateral
C2 . Bilateral
C3 . Associated with Acetabular Fracture

9. MANEGEMENT
• Aggressive treatment .
• Obtain X-Ray: AP pelvic, Inlet ,outlet ,Ct Scan.

14. Treatment
• Aggressive treatment . By A.B.C.D.
• Obtain X-Ray: AP pelvic, Inlet ,outlet
• Ct Scan.
• Think in systemic approach.
• Specific treatment:
type A . symptomatic treatment
type B .ORIF with plates& screws ,External Fix.
Type C . ORIF with plates & screws. Both AP.

17. Acetabular fracture
• Usually it is a result of high- energy trauma .
• The acetabulum is divided into four
segments—an anterior column and wall (rim)
and a posterior column and wall (rim). .
Fractures of the acetabulum are classified
based on their involvement of these
structures .

19. classification Letournel and Judet

25. Fractures of the Spine
Stability of vertebrae is maintained by :
♥ strong ligaments :
- ant. & post. longitudinal lig.
- interspinus ,supraspinus lig.,
and ligamentum flavum
♥ articular facets :
- vertical in D – L vertebrae
- horizontal in Cx vertebrae.
♥ Intervertebral discs.

26. Types of fracture spine
♥ stable fr. : - wedge fr.
- comminuted fr.
♥ unstable fr. : - fr. dislocation.
Usually caused by :
- hyper flexion injury,
- vertical compression,
- rarely hyper-extension .

27. Wedge fracture L 2

28. Complications
♥ in unstable fr.- dislocations, complete trans-section
of the cord may occur, leading to permanent
paraplegia, with its dangerous complications of
prolonged bed recumbency .
♥ PARAPLEGIA ..
due to damage or compression of
the spinal cord.

29. Treatment
♥ 1st. aid : patient transferred
with max. care to prevent
cord injury.
♥ Stable fr. : bed rest, then
back support brace.
♥ Unstable fr. : O.R.I.F. + cord
decompression.

30. Injuries of the cervical spine

31. ♥ pure dislocation may occur
without fracture, due to
horizontal position of
articular facets.

32. Hyper- extension injury of C2 – C3
( Hanging )