Pelvic Ring Fractures

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 24, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 2.50
Procedures: 2.50
Head, Spine, and Musculoskeletal: 2.50

Radiography: 2.50
Procedures: 2.50
Head, Spine and Pelvis Procedures: 2.50

Registered Radiologist Assistant: 3.00
Procedures: 3.00
Musculoskeletal and Endocrine Sections: 3.00

Outline

1. Introduction
2. Relevant Anatomy and Biomechanics of the Pelvis
3. Imaging Evaluation
4. Pelvic Ring Injuries
5. Classification of Pelvic Fractures
6. Lateral Compression Injury
7. AP Compression Injury
8. Vertical Shear Injury
9. Combined Mechanism Injury
10. Conclusion

Objectives

Upon completion of this course, students will:

1. describe the most common causes of displaced pelvic ring fractures
2. understand why pelvic ring fractures increase the risk of patient mortality
3. describe complications that may occur as a result of pelvic ring fracture
4. describe the basic anatomy of the pelvic ring
5. understand the biomechanical functionality of the pelvic ring
6. name the ligaments that make up the pelvic rim
7. know which ligament in the pelvic rim resists vertical shear and flexion forces
8. name the vascular structure that supplies most of the blood to the pelvic wall and viscera
9. know the location and anatomic importance of the ASIS
10. name the radiographic projections on which anterior ring fractures are most often evident
11. describe the anatomy best visualized by the pelvic outlet radiographic projection
12. describe the anatomy best visualized by the pelvic inlet radiographic projection
13. describe the x-ray tube angle and central ray position used to obtain the pelvic outlet projection
14. describe the x-ray tube angle and central ray position used to obtain the pelvic inlet projection
15. describe the anatomy best visualized by the Judet radiographic projections of the pelvis
16. describe the degree of patient obliquity used when acquiring a Judet view of the pelvis
17. understand how image reconstruction is used when performing CT of the pelvis to rule out fractures
18. know why MR imaging plays a limited role in imaging patients with polytrauma
19. name the types of pelvic fractures that tend to displace over time when exposed to normal physiologic loading
20. be familiar with the Letournel and Judet classification system of pelvic ring injuries
21. be familiar with the Tile classification system of pelvic ring injuries
22. be familiar with the Young and Burgess classification system of pelvic ring injuries
23. know what is used to assist in the visualization of posterior sacral fractures
24. describe lateral compression type 1, 2, and 3 injuries
25. know other terms for pelvis lateral compression type 3 injuries
26. describe how the disruption of certain ligaments can cause lateral compression type 3 injuries to be unstable
27. describe which anatomic region of the pelvis is the first point of failure In AP compression injuries
28. understand the naming of pelvic type 2 AP compression injuries in which there is external rotation of one or both hemipelvises
29. know the indications of posterior ring injury and the independent predictors of instability of the pelvis
30. describe what causes vertical shear fractures of the pelvis
31. understand vertical shear fractures of the pelvis and how they are related to age
32. describe conventional radiographic views that best depict cranial and posterior displacement of the iliac bone
33. know how medical imaging can assist in diagnosing associated injuries from pelvic vertical shear trauma to the urethra
34. know where urethral ruptures typically occur due to pelvic ring trauma injuries
35. be familiar with combined mechanism pelvic ring injuries