Q) A 25 year old man had a RTA and was found to have a fracture of the pubic ramus with displacement, and was hemodynamically stable. What is the management?
a) Bed rest and analgesics
b) Hammock sling traction
c) Open reduction and internal fixation
d) Skeletal traction
Ans: a) (Maheshwari 3rd,revised Ed., 107)
The various treatment modalities of pelvic fractures are:
1. Minimal or no displacement:
The patient is advised absolute bed rest for 3-4 weeks. Gradual mobolisation and weight bearing is permitted once the fractures become “sticky”.
2. Injury with anterior opening of the pelvis:
A minimal opening less than 2.5 cms does not need any more special treatment other that as above.reduction is needed if the opening is more then 2.5 cm. the various methods for this are:
· Plaster spica
· Hammock-sling traction
· External fixation
· Internal fixation
3. Injuries with vertical displacement:
These are treated with bilateral upper tibial skeletal traction.
4. There is a trend now-a-days towards ORIF which allows early mobilization of the patient.
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