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Question 6#

Each of the following is associated with pelvic fracture EXCEPT:

A. Prompt operative intervention for pubic rami fractures
B. Life-threatening hemorrhage
C. Associated genitourinary (GU) injury
D. Displacement associated with two or more fractures in the pelvic ring

Correct Answer is A

Comment:

Pelvic fractures are indicative of high energy trauma and are associated with head, chest, abdominal, and urogenital injuries. Hemorrhage from pelvic trauma can be life-threatening and patients can present with hemodynamic instability, requiring significant fluid resuscitation, and blood transfusions. The bleeding that occurs is often due to injury to the venous plexus in the posterior pelvis, though it can also be due to a large vessel injury such as a gluteal artery. Other associated injuries are bladder and urethral injuries that manifest with bleeding from the urethral meatus or blood in the catheter and need to be assessed with a retrograde urethrogram. The pelvis is a ring structure made up of the sacrum and the two innominate bones that are held together by strong ligaments. Because it is a ring, displacement can only occur if the ring is disrupted in two places. Displaced sacral fractures and iliac wing fractures are treated with screws or plates, while pubic rami fractures can usually be managed nonoperatively.