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Classification of Anterior Pelvic Injuries

- Discussion:
    - diastases: (45%) (may be associated w/ SI ligaments or Malgaigne frx);
             - three types of diastases:
                     - open-book type;
                     - vertical-displacement type;
                     - posterior-displacement type;
    - straddle fractures;
             - straddle frxs (free-floating symphyses) accounted for 20 % of frx;
             - > 50% pts had bladder or urethra injury;
             - nondisplaced frx require only symptomatic care;
             - displaced frx, esp w/ urinary tract injury, require stabilization;
             - w/ free-floating symphysis, contraction of abdominal muscles such as that which occurs with coughing produces pain, frx displacement, and soft tissue injury;
             - presence of straddle frx should alert for possibility of intr-abdominal or urethral injury;
                      - 33% of pts w/ straddle fractures required laparotomy;
    - intraarticular fractures: (5%)
             - mechanism of frx was same in these injuries, consisting of lateral compressive force against pelvis w/ hyperextension or hyper-abduction of the thigh;
             - intraarticular frx present no problem in terms of management and usually healed with synostosis of the symphysis;
             - overlapping pubic bones are assoc w/ urethral injuries, & residual disability accompanies failure of reduction;
             - overlapping dislocations;
             - combination fracture-dislocations