Injuries of Lower Limb
Crescent fracture is:
|A||Anterior posterior compression fracture|
|B||Fracture of pubic rami with sacroiliac fracture|
|C||Pubic diastasis with fracture of pubic rami|
|D||Dislocation of SI joint with fracture of iliac blade|
Dislocation of SI joint with fracture of iliac blade
a. Crescent Fractures is a fracture of the pelvis in which there is disruption of the sacroiliac joint
b. and the fracture line extends to the neighbouring iliac wing such that a small crescent shaped fragment of the posterior iliac wing remains attached to the sacrum, this is a lateral compression type of injury.
c. Crescent fracture dislocations are a wellrecognized subset of pelvic ring injuries which
d. Result from a lateral compression force. They are characterized by disruption of the sacroiliac
e. joint and extend proximally as a fracture of the posterior iliac wing.
f. It is rotationally unstable and vertically stable because sacrospinous and sacrotuberous
g. ligaments remain intact.
h. These iliac fractures may be associated with gluteal vascular injuries.
i. Treatment of choice is percutaneous screw fixation.
a. Pelvic injuries:
a. Straddle fracture – bilateral pubic rami fracture.
b. Open book injury – rotationally unstable hinges on posterior ligaments.
c. Bucket handle – rotationally unstable SI joint injury opposite to pubic rami.
d. Malgaigne fracture – pubic symphysis/ rami+SI joint same side
b. Jumper fracture: Injury is usually seen after falling from a height. There is dissociation of central portion of sacrum through its weakest portion i.e. through neural foramina from its lateral portion. Injury to sacral nerve roots or cauda equina lesion may also occur. Treatment is open reduction and internal fixation.
c. Destot sign: A large hematoma present in the inguinal region or in scrotal region.