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Pelvic fractures are commonly associated with other big injuries and blood loss. If there is any suggestion of either of these being present, please discuss with the major trauma centre.
|Stable injuries: include avulsion fractures, isolated pubic ramus fractures, iliac wing fractures and single-bone stable fractures. These occur at the point of attachment of muscles: Anterior inferior iliac spine: rectus femoris; often resulting from a mis-kick into the ground. Anterior superior iliac spine: sartorius. Ischial tuberosity: hamstrings.
|Rotationally unstable but vertically stable. B1: 'open book fracture' - these are anteroposterior compression (APC) fractures, causing separation of the pubic symphysis and widening of one or both sacroiliac (SI) joints. Rotationally unstable but vertically stable.
|ipsilateral compression causing the pubic bones to fracture and override.
|contralateral compression injury resulting in pubic rami fractures on one side and compression SI injury on the other side.
|Rotationally and vertically unstable. The pelvic ring is completely disrupted or is displaced at two or more points. Associated with massive blood loss and very high mortality. Subdivided into: C1: unilateral. C2: bilateral. C3: also involving acetabular fracture.