英文视频教学｜骨盆骨折
pelvic fracture overview
Anatomy
you find here the SI joint, the ischium, pubic bone, symphysis pubis, ilium, sacrum and the strong sacroiliac ligaments.
the sacroiliac joint has posterior ligaments that is very strong and the stability of the pelvis depend on the integrity of the posterior weight-bearing sacroiliac joint complex and transfer the weight from the spine to the lower extremity or care through that joint.
pelvis is earring.
when a force occurs between injured ring in the front and the back
anterior your injury
and the posterior injury
the anterior injury is usually obviously be noted on radiograph and usually associated with a posterior injury or a fracture.
the posterior injury could be occult always look at the back of the pelvis.
unstable pelvis will have a gap or comminution.
the posterior fracture is serious. We need significant blood transfusion.
we need surgery and the outcome will be unpredictable.
that posterior fracture is a serious injury that will lead to any stability of the pelvis and a lot of bleeding.
this bony instability
if it is not corrected surgically it can cause (lead) deformity limb length, discrepancy and pain.
types of pelvic fractures are three types: anteroposterior type, lateral compression type, and the bad vertical shear type.
the first type in the anteroposterior compression type. you can have that with pubic rami fracture as you can see here in the slide or you can have it as an open-book type when the symphysis pubis opens up. we call it symphysis pubis diastasis.
treatment
close the book
pelvic binder or slang surgery if the symphysis pubis diastasis is more than 2.5 centimeter.
the surgery can be done through an external factor or a plate. this is an example of external factor of the pelvis. this is an example of interior plate. you can see here at the incision after you reach the bone. you will try to reduce the disruption of the symphysis pubis. then you fix the symphysis pubis with the plate.
the lateral compression type
it is the most common type of fracture and is usually impacted and not displaced. It has a good prognosis (and) usually doesn't require surgical fixation.
the third type is the vertical shear fracture. it is a bad fracture.it needs surgery anteriorly and posteriorly. it needs blood transfusion and extensive blood transfusion. outcome is guarded. initial external factor may be needed to control the bleeding. you probably will use traction in the emergency room which will reduce the vertical displacement and decrease the motion at the fracture site. you may also use a pelvic binder in the emergency room. vertical shear fracture are stabilized surgically by anterior stabilisation using plates.
reduction of the symphysis pubis is done before fixation. and here is the interior fixation.
usually this fracture would need to be fixed posteriorly.
we usually use posterior screw fixation. you can see a CT scan that shows the posterior screw fixation.
All my videos and this video is for educational purposes only. please consult your doctor before you make any decision about your medical care.
重点词汇汇总：
SI joint = sacroiliac joint 骶髂关节
symphysis pubis 耻骨联合
radiograph /'redɪoɡræf/n. 射线照片；X光照片vt. [核] 拍射线照片
pubic rami 耻骨支
pubis diastasis耻骨分离
/dai'æstəsis/n. 脱骱；心休息期
百度翻译：
骨盆骨折概述
解剖
你可以在这里找到骶髂关节，坐骨，耻骨，耻骨联合，髂骨，骶骨和强大的骶髂韧带。
骶髂关节有非常坚固的后韧带，骨盆的稳定性取决于后承重骶髂关节复合体的完整性，并将重量从脊柱转移到下肢或通过该关节进行护理。
骨盆环。
当一个力发生在前面和后面的受伤环之间
在你受伤之前
后面的伤呢
前路损伤通常在x线片上明显可见，常伴有后路损伤或骨折。
后面的损伤可能是隐匿性的总是看骨盆后部。
不稳定的骨盆会有间隙或粉碎。
后路骨折严重。我们需要大量输血。
我们需要手术，结果是不可预测的。
后路骨折是一种严重的损伤，会导致骨盆的任何稳定性和大量出血。
这种骨性的不稳定
如果不进行手术矫正，可能导致肢体长度、不一致和疼痛。
骨盆骨折分为三种类型：前后向型、侧向压缩型和垂直剪切不良型。
前后压迫型中的第一种。你可以有耻骨支骨折，如幻灯片所示，或者当耻骨联合开放时，你可以将其作为一种开卷类型。我们称之为耻骨联合分离。
治疗
开书型损伤
如果耻骨联合分离超过2.5厘米，则进行骨盆捆绑术或俚语手术。
手术可以通过外部因素或钢板完成。这是骨盆外部因素的一个例子。这是一个内板的例子。你可以看到这里的切口，当你到达骨头。你要尽量减少耻骨联合的破坏。然后用钢板固定耻骨联合。
侧向压缩型
它是最常见的骨折类型，通常受到撞击而不移位。预后良好，通常不需要手术固定。
第三类为垂直剪切断裂。这是个坏消息骨折前后都需要手术。它需要输血和大量输血。结果是保守的。为了控制出血，可能需要初始的外部因素。你可能会在急诊室使用牵引，这样可以减少垂直位移，减少骨折部位的运动。你也可以在急诊室使用骨盆活页夹。垂直剪切性骨折通过使用钢板的前固定进行手术稳定。
固定前耻骨联合复位。这是内部固定。
通常这种骨折需要在后方固定。
我们通常使用后路螺钉固定。你可以看到CT扫描显示后路螺钉固定。
我所有的视频和这个视频只是为了教育目的。在你决定你的医疗保健之前，请咨询你的医生。