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Duverney Fracture
Duverney fractures are isolated pelvic fractures involving only the iliac wing. They are caused by direct trauma to the iliac wing, and are generally stable fractures as they do not disrupt the weight bearing pelvic ring. The fracture is named after the French surgeon Joseph Guichard Duverney who described the injury in his book ''Maladies des Os'' which was published posthumously in 1751. Presentation Complications Malunion and deformity of the iliac wing can occur. Injury to the internal iliac artery can occur, leading to hypovolaemic shock. Perforation of the bowel can occur, leading to sepsis. Damage to the adjacent nerves of the lumbosacral plexus has also been described. Diagnosis Duverney fractures can usually be seen on pelvic X-rays, but CT scans are required to fully delineate the fracture and to look for associated fractures involving the pelvic ring. Management Since fractures that do not involve the weight bearing part of the pelvic ring tend to be stable f ...
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Pelvic Fracture
A pelvic fracture is a break of the bony structure of the pelvis. This includes any break of the sacrum, hip bones (ischium, pubis, ilium), or tailbone. Symptoms include pain, particularly with movement. Complications may include internal bleeding, injury to the bladder, or vaginal trauma. Common causes include falls, motor vehicle collisions, a vehicle hitting a pedestrian, or a direct crush injury. In younger people significant trauma is typically required while in older people less significant trauma can result in a fracture. They are divided into two types: stable and unstable. Unstable fractures are further divided into anterior posterior compression, lateral compression, vertical shear, and combined mechanism fractures. Diagnosis is suspected based on symptoms and examination with confirmation by X-rays or CT scan. If a person is fully awake and has no pain of the pelvis medical imaging is not needed. Emergency treatment generally follows advanced trauma life sup ...
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Gastrointestinal Perforation
Gastrointestinal perforation, also known as ruptured bowel, is a hole in the wall of part of the gastrointestinal tract. The gastrointestinal tract includes the esophagus, stomach, small intestine, and large intestine. Symptoms include severe abdominal pain and tenderness. When the hole is in the stomach or early part of the small intestine, the onset of pain is typically sudden while with a hole in the large intestine onset may be more gradual. The pain is usually constant in nature. Sepsis, with an increased heart rate, increased breathing rate, fever, and confusion may occur. The cause can include trauma such as from a knife wound, eating a sharp object, or a medical procedure such as colonoscopy, bowel obstruction such as from a volvulus, colon cancer, or diverticulitis, stomach ulcers, ischemic bowel, and a number of infections including '' C. difficile''. A hole allows intestinal contents to enter the abdominal cavity. The entry of bacteria results in a condition kn ...
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Walker (mobility)
A walker (North American English) or walking frame (British English) is a device that gives support to maintain balance or stability while walking, most commonly due to age-related mobility disability, including frailty. Another common equivalent term for a walker is a Zimmer (frame), a genericised trademark from Zimmer Biomet, a major manufacturer of such devices and joint replacement parts. Walking frames have two front wheels, and there are also wheeled walkers available having three or four wheels, also known as rollators. Walkers started appearing in the early 1950s. The first US patent was awarded in 1953 to William Cribbes Robb, of Stretford, UK, for a device called "walking aid", which had been filed with the British patent office in August 1949. Two variants with wheels were both awarded US patents in May 1957, and the first non-wheeled design that was called a "walker" was patented in 1965 by Elmer F. Ries of Cincinnati, Ohio. The first walker to resemble modern walke ...
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Crutch
A crutch is a mobility aid that transfers weight from the legs to the upper body. It is often used by people who cannot use their legs to support their weight, for reasons ranging from short-term injuries to lifelong disabilities. History Crutches were used in ancient Egypt. In 1917, Emile Schlick patented the first commercially produced crutch; the design consisted of a walking stick with an upper arm support. Later, A.R. Lofstrand Jr. developed the first crutches with a height-adjustable feature. Over time, the design of crutches has not changed much, and the classic design continues to be the most commonly used. Types There are several types of crutches: Underarm or axillary Axillary crutches are used by placing the pad against the ribcage beneath the armpit and holding the grip, which is below and parallel to the pad. They are usually used to provide support for patients who have temporary restriction on ambulation.Taylor, C. R., Lillis, C., LeMone, P., Lynn, P. (2011) F ...
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Radiography
Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeutic") and industrial radiography. Similar techniques are used in airport security (where "body scanners" generally use backscatter X-ray). To create an image in conventional radiography, a beam of X-rays is produced by an X-ray generator and is projected toward the object. A certain amount of the X-rays or other radiation is absorbed by the object, dependent on the object's density and structural composition. The X-rays that pass through the object are captured behind the object by a detector (either photographic film or a digital detector). The generation of flat two dimensional images by this technique is called projectional radiography. In computed tomography (CT scanning) an X-ray source and its associated detectors rotate around the su ...
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Lumbosacral Plexus
The anterior divisions of the lumbar nerves, sacral nerves, and coccygeal nerve form the lumbosacral plexus, the first lumbar nerve being frequently joined by a branch from the twelfth thoracic. For descriptive purposes this plexus is usually divided into three parts: * lumbar plexus * sacral plexus * pudendal plexus Injuries to the lumbosacral plexus are predominantly witnessed as bone injuries. Lumbosacral trunk and sacral plexus In human anatomy, the sacral plexus is a nerve plexus which provides motor and sensory nerves for the posterior thigh, most of the lower leg and foot, and part of the pelvis. It is part of the lumbosacral plexus and emerges from the lumbar verte ... palsies are common injury patterns. References External links * - "Lumbosacral Plexus" Additional Images File:Slide2Anat.JPG, Lumbosacral plexus Deep dissection. File:Slide4Anat.JPG, Lumbosacral plexus Deep dissection. Nerve plexus Nerves of the lower limb and lower torso {{Neuroana ...
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Sepsis
Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is followed by suppression of the immune system. Common signs and symptoms include fever, tachycardia, increased heart rate, hyperventilation, increased breathing rate, and mental confusion, confusion. There may also be symptoms related to a specific infection, such as a cough with pneumonia, or dysuria, painful urination with a pyelonephritis, kidney infection. The very young, old, and people with a immunodeficiency, weakened immune system may have no symptoms of a specific infection, and the hypothermia, body temperature may be low or normal instead of having a fever. Severe sepsis causes organ dysfunction, poor organ function or blood flow. The presence of Hypotension, low blood pressure, high blood Lactic acid, lactate, or Oliguria, low urine o ...
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Colon (anatomy)
The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Water is absorbed here and the remaining waste material is stored in the rectum as feces before being removed by defecation. The colon is the longest portion of the large intestine, and the terms are often used interchangeably but most sources define the large intestine as the combination of the cecum, colon, rectum, and anal canal. Some other sources exclude the anal canal. In humans, the large intestine begins in the right iliac region of the pelvis, just at or below the waist, where it is joined to the end of the small intestine at the cecum, via the ileocecal valve. It then continues as the colon ascending the abdomen, across the width of the abdominal cavity as the transverse colon, and then descending to the rectum and its endpoint at the anal canal. Overall, in humans, the large intestine is about long, which is about one-fifth o ...
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Shock (circulatory)
Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thirst. This may be followed by confusion, unconsciousness, or cardiac arrest, as complications worsen. Shock is divided into four main types based on the underlying cause: low volume, cardiogenic, obstructive, and distributive shock. Low volume shock, also known as hypovolemic shock, may be from bleeding, diarrhea, or vomiting. Cardiogenic shock may be due to a heart attack or cardiac contusion. Obstructive shock may be due to cardiac tamponade or a tension pneumothorax. Distributive shock may be due to sepsis, anaphylaxis, injury to the upper spinal cord, or certain overdoses. The diagnosis is generally based on a combination of symptoms, physical examination, and laboratory tests. A decreased pulse pressure (systolic blood pressure m ...
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Ilium (bone)
The ilium () (plural ilia) is the uppermost and largest part of the hip bone, and appears in most vertebrates including mammals and birds, but not bony fish. All reptiles have an ilium except snakes, although some snake species have a tiny bone which is considered to be an ilium. The ilium of the human is divisible into two parts, the body and the wing; the separation is indicated on the top surface by a curved line, the arcuate line, and on the external surface by the margin of the acetabulum. The name comes from the Latin (''ile'', ''ilis''), meaning "groin" or "flank". Structure The ilium consists of the body and wing. Together with the ischium and pubis, to which the ilium is connected, these form the pelvic bone, with only a faint line indicating the place of union. The body ( la, corpus) forms less than two-fifths of the acetabulum; and also forms part of the acetabular fossa. The internal surface of the body is part of the wall of the lesser pelvis and gives ...
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Hypovolemia
Hypovolemia, also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body. This may be due to either a loss of both salt and water or a decrease in blood volume. Hypovolemia refers to the loss of extracellular fluid and should not be confused with dehydration. Hypovolemia is caused by a variety of events, but these can be simplified into two categories: those that are associated with kidney function and those that are not. The signs and symptoms of hypovolemia worsen as the amount of fluid lost increases. Immediately or shortly after mild fluid loss (from blood donation, diarrhea, vomiting, bleeding from trauma, etc.), one may experience headache, fatigue, weakness, dizziness, or thirst. Untreated hypovolemia or excessive and rapid losses of volume may lead to hypovolemic shock. Signs and symptoms of hypovolemic shock include increased heart rate, low blood pressure, pale or cold skin, and altered mental status. When these ...
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Internal Iliac Artery
The internal iliac artery (formerly known as the hypogastric artery) is the main artery of the pelvis. Structure The internal iliac artery supplies the walls and viscera of the pelvis, the buttock, the reproductive organs, and the medial compartment of the thigh. The vesicular branches of the internal iliac arteries supply the bladder. It is a short, thick vessel, smaller than the external iliac artery, and about 3 to 4 cm in length. Course The internal iliac artery arises at the bifurcation of the common iliac artery, opposite the lumbosacral articulation, and, passing downward to the upper margin of the greater sciatic foramen, divides into two large trunks, an anterior and a posterior. It is posterior to the ureter, anterior to the internal iliac vein, anterior to the lumbosacral trunk, and anterior to the piriformis muscle. Near its origin, it is medial to the external iliac vein, which lies between it and the psoas major muscle. It is above the obturator nerve. Bra ...
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