Executive Editor: Peter Trafton

Authors: Rahul Banerjee, Peter Brink, Matej Cimerman, Tim Pohlemann, Matevz Tomazevic

Pelvic ring - C2

back to skeleton

Glossary

General considerations

Before proceeding with definitive repairs, the patient must be fully resuscitated, fully evaluated, and fit for anesthesia and surgery by a prepared team.

C2 pelvic ring injuries are bilaterally unstable. Posteriorly, one side is a completely unstable (C1) injury and the other is a rotationally unstable (B1 or B2) injury. Various anterior pelvic arch injury patterns and locations are possible. In almost all cases, definitive management involves comprehensive reduction and surgical fixation procedures, to restore pelvic anatomy and symmetry as well as stability at each injury site.

External fixation and traction (resource-limited)
Main indication Skill Equipment
Unstable pelvic injury without availability of posterior ring fixation Some specialized surgical experience Basic equipment only

Indications

  • Unstable pelvic injury without availability of posterior ring fixation
  • Proximal displacement of the involved hemipelvis or risk thereof
  • Need to delay definitive surgery because of patient's condition

Contraindications

  • Availability of comprehensive pelvic ring fixation without excessive delay
  • Skeletal traction should not be applied if the involved hemipelvis is distally &/or anteriorly displaced. A circumferential wrap should be applied.
Operative treatment
Main indication Skill Equipment
C2 pelvic ring injury Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Before proceeding with definitive repairs, the patient must be fully resuscitated, fully evaluated, and fit for anesthesia and surgery by a prepared team.

Indications

  • C2 pelvic ring injury
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

2016-10-20