You are called to the scene of a two-car head-on auto accident. Circumferential stabilization of a Malgaigne fracture lessens the potential for blood loss and reduces the patient’s pain by limiting movement of the injured pelvis. Pelvic stabilization with a mechanical device or pelvic sheet wrap is indicated for any patient with pelvic instability. The primary goal is stabilization of the fracture and prevention of further hemorrhage loss. Management strategies for a Malgaigne fracture are similar to any unstable pelvic fracture. Tumbling falls where one foot hits the ground prior to the other, at the end of the tumble.Vertical falls where one foot hits the ground prior to the other.Here are the two most common mechanism of injuries associated with shearing forces to the pelvis: Malgaigne fractures are caused by shearing forces to the pelvis. Although hip fractures are significant injuries, patients typically do not lose as much blood volume as with an unstable hip fracture.Ĭorrelating probable mechanism of injury for a Malgaigne fracture is crucial to identifying the injury. If the patient presents with shortening of one leg, it is important the EMS provider NOT mistake a Malgaigne fracture for a hip fracture. This results in an unstable unilateral fragment of the pelvis which contains the acetabular hip joint.īased on the injury pattern, a common clinical presentation for a Malgaigne fracture is leg shortening on the affected side. It typically involves one half of the pelvis, which is comprised of a dislocation of the sacroiliac joint on the back and a fracture of the pubic rami on the front. The patient denies loss of consciousness and has good circulation, movement and sensation of all extremities.īased on the mechanism of injury and patient presentation, what type of injury do you think is associated with a Malgaigne fracture?Ī Malgaigne fracture is a vertical pelvic injury that involves multiple breaks of the pelvic bone. It is difficult to validate, but you notice there may be shortening of the patient’s right leg. The pain associated with all these areas is aggravated by palpation and movement. The patient is complaining of pain to the head, neck, back and hip. You are called to a parking structure on a 23-year-old male who has tumbled down 10-12 concrete stairs. What might be surprising is some orthopedic injuries are recognized by specific medical designations. These injuries are highly unstable and often involve other abdominal injuries.Prehospital providers frequently encounter patients with various fractures and related injuries. In a Chance fracture, the bony elements of the spine are fractured but the ligaments remain intact. In children, this injury usually happens lower on the spine, in the area known as the mid-lumbar region. In the case of a Chance fracture, all three columns are involved, and the fracture line runs through the spine, injuring the lamina, pedicles, and vertebral body. The posterior column is represented by the pedicles, facet joints, lamina, spinous and transverse processes, and ligamentous complex. The middle column contains the posterior half of the vertebral body, its associated disc, and posterior longitudinal ligament. It consists of the anterior half of the vertebral body, disc, and anterior longitudinal ligament. The first column is known as the anterior column. The thoracolumbar spine has three columns. They typically involve the 12th thoracic vertebra and first or second lumbar vertebra. A Chance fracture is one of three types of injuries resulting from these forces, which can injure the bone, ligaments, and discs of the spine.Ĭhance fractures most commonly occur in an area of the spine called the thoracolumbar junction (where the thoracic spine joins the lumbar spine). This is when the spine flexes, and then extends with too much force. Chance in 1948, a Chance fracture is caused by flexion-distraction forces upon the spine. Since the addition of the shoulder belt, these injuries are much less common.įirst described by G. This is because they’re commonly caused by lap belt-style seat belts during car accidents. Chance fractures are also known as seat belt fractures. A Chance fracture is a type of spinal injury.
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