Duverney fractures are isolated

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 ble ...

s 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 In orthopedics, weight-bearing is the amount of weight a patient puts on an injured body part. Generally, it refers to a leg, ankle or foot that has been fractured or upon which surgery has been performed, but the term can also be used to refer to r ...

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 A deformity, dysmorphism, or dysmorphic feature is a major abnormality of an organism that makes a part of the body appear or function differently than how it is supposed to. Causes Deformity can be caused by a variety of factors: *Arthritis an ...

of the iliac wing can occur. Injury to the

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 compart ...

can occur, leading to hypovolaemic

shock Shock may refer to: Common uses Collective noun *Shock, a historic commercial term for a group of 60, see English numerals#Special names * Stook, or shock of grain, stacked sheaves Healthcare * Shock (circulatory), circulatory medical emergen ...

Perforation A perforation is a small hole in a thin material or web. There is usually more than one perforation in an organized fashion, where all of the holes collectively are called a ''perforation''. The process of creating perforations is called perfor ...

of the

bowel The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...

can occur, leading to

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 follo ...

. Damage to the adjacent nerves of the

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 divi ...

has also been described.

Diagnosis

Duverney fractures can usually be seen on pelvic

X-rays An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 Picometre, picometers to 10 Nanometre, nanometers, corresponding to frequency, ...

, 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 fractures, they can often be managed without surgery. These fractures tend to be very painful, so walking aids such as

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 Crutc ...

es or

walking frames 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 equival ...

may be needed until the pain settles.

Open reduction internal fixation Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the m ...

is sometimes required to correct deformity, and surgery may be required if there is damage to blood vessels, nerves or organs, or if the fracture is open.Iliac wing fractures
at Orthopaedia.com

References

{{Fractures Bone fractures