Challenge of the Week / Trauma / 10.23.2020

You are assessing a 37-year-old male patient with an anterior-posterior compression (APC) type-2 pelvic ring injury. The injury has been stabilized with a pelvic external fixator and the patient is hemodynamically stable 3 days posttrauma. Which of the following is the definitive management of the patient’s pelvic injury?
    • Anterior symphyseal plating with or without posterior stabilization
    • APC type-2 injuries are defined by anterior diastasis of >2.5 cm and anterior sacroiliac joint widening, and require anterior stabilization with possible posterior stabilization

 

    • Allow the patient to bear weight as tolerated
    • Displacement of the pubic symphysis with >2.5 cm diastasis is an indication for operative stabilization

 

    • Protected weight-bearing
    • APC type-1 or lateral compression type-1 injuries can be treated nonoperatively with protected weight-bearing due to the low likelihood of further displacement

 

    • Posterior stabilization with plate alone
    • Vertical shear injuries are unstable with complete disruption of all ligamentous supporting structures and require operative stabilization of anterior and posterior injuries with a possible posterior plate

     

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