MEDICO LEGAL M A G A Z I N E
FRACTURES OF THE PELVIC RING By Mr Nikhil Shah Mr Shah is a Trauma and Orthopaedic Surgery Consultant at Wrightington Hospital in Lancashire with special interests including long bone and joint periarticular fractures, pelvic and acetabular fractures, hip and knee replacement. He has extensive medico-legal experience, including multiple/polytrauma accidents and catastrophic injury, clinical negligence, work-related accidents, low velocity impact whiplash and fraud and injury overseas. The pelvis is the strong and sturdy ring of bones located at the base of the spine. It links the bottom of the spine to the lower limbs. Fractures of the pelvis are relatively uncommon. But they can be life threatening injuries. Management of pelvic ring has evolved and advanced over the last 4-5 decades due to the efforts of many pioneering surgeons, particularly Letournel and Judet in France and Pennal and Tile in North America, to name just a few. Most pelvic fractures are caused by some type of trauma, a high-energy event, such as a car collision or
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Sp o n s o re d by:
a fall from a height. The pelvis contains and protects major blood vessels, nerves, and important organs, and so pelvic fractures may cause extensive bleeding and other injuries that require urgent treatment. Treatment for a pelvic fracture varies depending on the severity of the injury. While lower-energy fractures can often be managed without surgery, treatment for high-energy pelvic fractures usually involves surgery to reconstruct the pelvis and restore stability of the ring, so that patients can regain the ability for early walking and return to function.
Medico-Legal Relevance Most pelvic fractures are caused by some type of traumatic, high-energy event, such as a car collision. Some of them occur from crush injuries at work, fall from ladders, fall through a roof, pedestrians hit by vehicles, and hence these injuries give rise to quite a few personal injury claims. In some cases, a lower-impact event—such as a minor fall—may be enough to cause a pelvic fracture in an older
