Saturday, March 17, 2007

Pelvis Fixation

What is Pelvis?

The pelvis is the bony ring like structure located at the base of the spine. The pelvis incorporates the socket portion of the hip joint for each leg. It forms the lower limb (or hind-limb) girdle of the skeleton. Strong connective tissues (ligaments) join the pelvis to the large triangular bone (sacrum) at the base of the spine. This creates a bowl-like cavity below the rib cage. On each side, there is a hollow cup (acetabulum) that serves as the socket for the hip joint.


Purpose of the Pelvis

The pelvis protects the digestive and reproductive organs in the lower part of the body, and many large nerves and blood vessels pass through it to supply to the legs. It is also an important load-bearing part of the skeletal system. It also provides a connection between the axial skeleton and the hind limbs, that is, the legs. The hind limb consists of several bones such as the femur, tibia, fibula, tarsus, metatarsus and phalanges. The femur is the largest bone in the human body. Its lower end articulates with the tibia to form a hinge joint at the knee. The fibula is a shorter and smaller bone. Both the tibia and fibula form joints with the tarsus at the ankle.


Pelvis Fracture

Pelvic fracture is a disruption of the bony structure of the pelvis. The most common cause in elderly is a fall, but the most significant fractures involve high-energy forces such as a motor vehicle accident or a fall from significant height. Diagnosis is made on the basis of history, clinical features and special investigations usually including x-ray and CT. Pelvic fractures may produce significant bleeding. Emergency treatment consists of Advanced Trauma Life Support management. After stabilization, the pelvis may be surgically reconstructed.


Diagnosis

A broken pelvis is painful, often swollen and bruised. The individual may try to keep the hip or knee bent in a specific position to avoid aggravating the pain. If the fracture is due to trauma, there may also be injuries to the head, chest or legs. There is usually considerable bleeding, which can lead to shock. The injuries must be stabilized and the individual taken to a trauma center for definitive care. All pelvic fractures require X-rays, usually from different angles, to show the degree of displacement to the bones. A computed tomography (CT) scan may be ordered to define the extent of other injuries. The physician will also examine the blood vessels and nerves to the legs to see if they have been injured.


Treatment

Pelvic fractures that result from high-energy trauma are often life-threatening injuries because of the extensive bleeding. In these cases, doctors may use an external fixator to stabilize the pelvic area. This device has long screws that are inserted into the bones on each side and connected to a frame outside the body. The external fixator allows surgeons to address the internal injuries to organs, blood vessels and nerves.

What happens next depends on the type of fracture and the patient's condition. Each case must be assessed individually, particularly with unstable fractures. Some pelvic fractures may require traction; for others, the external fixator may be sufficient. Unstable fractures may require surgical insertion of plates or screws of a biocompatible metal.


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Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.