Dislocations
DR. Khalid Bakarman
Pediatric & trauma orthopedic
consultant
Topics
• Ace tabular fractures.
• Pelvic Fractures.
• Hip Dislocations.
• Proximal femoral fracture.
• Femoral Shaft Fractures.
• Fracture tibial plateau.
• Tibial shaft Fractures.
• Ankle fractures.
Mechanism of fractures
• Lower limb fracture is a result of a high
energy trauma except in elderly people or
diseased bones
• Types of fracture are depend on position of
limb during impaction and magnitude of
forces applied.
Management
• The proper way to treat a patient with high
energy trauma is to look at the patient as
whole ,not to injured limb alone!
• So the aim to treat such patient is to save life
first, then save limb ,finally to save function.
• A.B.C.D
Pelvic Fractures
• Pelvic fracture is a high energy trauma , as a
result of MVA, fall .
• Classifications. ( Tile)
Type A. Stable
A 1. fractures of the pelvic not involving the
Ring.
A 2 . Stable , minimally displaced fracture of
the Ring .
• Type B. Rotationally Unstable ,Vertically
Stable.
B1. Open Book
C1 . Unilateral
C2 . Bilateral
Stabilize pelvis
complications
A. Hemorrhage – life threatening
B. Bladder/bowel injuries
C. Neurological damage
D. Obstetrical difficulties
E. Persistent Sacro-iliac joint pain
F. Post –traumatic arthritis of the hip with
acetabular fractures
Acetabular fracture
• Usually it is a result of high- energy trauma .
• The acetabulum is divided into four
segments—an anterior column and wall (rim)
and a posterior column and wall (rim). .
Fractures of the acetabulum are classified
based on their involvement of these
structures .
classification Letournel and Judet
Investigation
• AP pelvis.
• Judat views ( Internal Oblique,Obturator view)
• C T scan .
TREATMENT