Journal
INTERNATIONAL ORTHOPAEDICS
Volume 42, Issue 11, Pages 2663-2674Publisher
SPRINGER
DOI: 10.1007/s00264-018-3883-1
Keywords
Vertical shear; Pelvic fracture; Pelvic ring injuries; Unstable pelvis; Combined mechanism; Young and Burgess; Tile C pelvic fractures; Unstable pelvic fractures
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Vertical shear pelvic ring fractures are rare and account for less than 1% of all fractures. Unlike severely displaced antero-posterior compression and lateral compression pelvic fractures, patients' mortality is lower. Nevertheless, patients must be managed acutely using well-defined ATLS protocols and institution-specific protocols for haemodynamically unstable pelvic ring fractures. The definitive treatment of vertical shear pelvic fractures is however more controversial with a paucity of literature to recommend the ideal reduction and fixation strategy. While the majority of injuries can be reduced and fixed in a closed manner, orthopaedic traumatologists should be familiar with the contraindications to those techniques as well as options such as tension band plating and lumbo pelvic fixation. Our paper reviews the acute management, associated injuries and definitive reduction and fixation strategies of vertical shear pelvic fractures. In addition, we propose a treatment algorithm for the selection of the most appropriate fixation technique.
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