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International Orthopaedics

, Volume 42, Issue 11, pp 2663–2674 | Cite as

Vertical shear pelvic injury: evaluation, management, and fixation strategies

  • Laura Blum
  • Mark E. Hake
  • Ryan Charles
  • Todd Conlan
  • David Rojas
  • Murphy Trey Martin
  • Cyril Mauffrey
Review Article

Abstract

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.

Keywords

Vertical shear Pelvic fracture Pelvic ring injuries Unstable pelvis Combined mechanism Young and Burgess Tile C pelvic fractures Unstable pelvic fractures 

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest to report in relation to the preparation of this work.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryUniversity of MichiganAnn ArborUSA
  2. 2.Department of Orthopaedics, Denver Health Medical CenterUniversity of Colorado, School of MedicineDenverUSA

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