Anteroposterior Compression Injuries APC ; pelvic ring fracture caused by force that pushes pelvis скачать в хорошем качестве

Anteroposterior Compression Injuries APC ; pelvic ring fracture caused by force that pushes pelvis

🦴 Anteroposterior Compression (APC) Injuries are a type of pelvic ring fracture caused by front-to-back forces, such as those sustained in head-on motor vehicle collisions. These injuries are part of the Young-Burgess classification system and are often referred to as "open-book" fractures due to the way the pelvis opens at the pubic symphysis. 💥 Mechanism of Injury Force is applied anteriorly, typically at the pubic symphysis or anterior superior iliac spines. This causes the pelvic ring to splay open, disrupting ligaments and potentially leading to hemodynamic instability due to vascular injury. 📊 Young-Burgess APC Classification Type Description Stability APC I Less than 2.5 cm pubic symphysis diastasis; ligaments stretched but intact Stable APC II Greater than 2.5 cm diastasis; disruption of anterior SI, sacrotuberous, sacrospinous ligs Rotationally unstable APC III Complete SI joint disruption; anterior and posterior ligaments torn Completely unstable APC II and III injuries often require surgical stabilization and carry a higher risk of massive hemorrhage2. 🧪 Diagnosis X-rays: Look for pubic symphysis widening and SI joint changes. CT scans: Assess ligamentous injury and posterior ring involvement. Stress views: May be used to detect subtle instability (e.g., flamingo views). 🛠️ Management APC I: Usually managed non-operatively with rest and pain control. APC II–III: Often require: External fixation or pelvic binders for initial stabilization Definitive surgical fixation (e.g., symphyseal plating, SI screws) Angioembolization if ongoing bleeding is suspected ⚠️ Complications Hemorrhagic shock Urethral or bladder injury (especially with symphyseal diastasis) Chronic pelvic instability or pain Neurologic deficits if sacral nerves are involved #Anteroposterior