Malgaigne pelvic fractures

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Motor vehicle collision. Ejected.

Patient Data

Age: 38
Gender: Male
x-ray
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Severely displaced fracture through the left ilium and inferior and superior pubic rami with disruption of the sacroiliac joint. Increased opacity over the left hemipelvis. Pelvic binder in-situ. 

ct
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Axial bone
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Coronal
bone window
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Sagittal
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3D
Pelvis
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Multiple pelvic fractures:

  • comminuted left ilium fracture extending to the SIJ
  • widening of the left SIJ
  • superior and inferior left pubic rami fractures
  • undisplaced left sacral ala fracture (best seen on sagittal plane)

Associated pelvic hematoma, which is large, displacing the bladder to the right and marked thickening of the distal iliopsoas muscle. 

Right pneumothorax. 

 

x-ray
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Extensive surgical correction with multiple screw implants across the sacrum and left iliac wing and left superior pubic ramus.

Case Discussion

This is an example of a Malgaigne fracture, which is an unstable type of pelvic fracture. It involves one hemipelvis, and results from vertical shear energy vectors. 

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