The anterior and posterior columns are connected to the axial skeleton through the sciatic buttress. The acetabulum is formed by the anterior and posterior columns and connected by the supra-acetabular region. The femoral head and the acetabulum form the hip joint. The anterior ligaments are the first to disrupt.įigure 5.1 (a)–(d) Normal pelvic and hip anatomy: 1, sacrum 2, sacro-iliac joint 3, ilium 4, iliac crest 5, anterior superior iliac spine 6, anterior inferior iliac spine 7, ischial spine 8, obturator foramen 9, superior pubic ramus 10, inferior pubic ramus 11, ischial tuberosity 12, symphysis pubis 13, femoral head 14, fovea centralis 15, posterior acetabular rim 16, acetabulum 17, neck of femur 18, inter-trochanteric line 19, greater trochanter 20, lesser trochanter 21, Kohler’s tear drop 22, Shenton’s line. The anterior group in contrast is weak and prevents distraction and anteroposterior displacement. The posterior group is strong and complex and attaches the spine to the pelvis. The ligaments are the anterior and posterior sacroiliac ligaments, the sacrotuberous ligament, sacrospinous ligaments and the ligaments of the symphysis pubis. The integrity of this pelvic bony ring can be compromised by disruption of these ligaments ( Figures 5.1 and 5.2). It comprises three separate bones (the sacrum and two iliac/innominate bones) which are held together by a series of strong ligaments. The pelvis is the connection between lower limb and trunk and hence it is inherently unstable. The fractures may be subtle on plain radiographs and may be overlooked in particular in obese and elderly osteopenic patients. In contrast, hip fractures may occur after relatively minor trauma in elderly patients and are suspected from the clinical history and examination. The mortality rate for closed pelvic fractures is 27% and that for open fractures is 55%. Prognosis is poor if the injuries are not detected and treated promptly. ![]() This results from internal visceral injuries (commonly bladder and urethra and rarely uterus, cervix, vagina and rectum) and bleeding due to high impact in RTAs, falls in young patients and associated underlying co-morbidities in elderly population. There is high morbidity and mortality associated with pelvic fractures. If an image is blurred, the X-ray technician might take another one.Pelvic and hip fractures are seen in the elderly population with trivial trauma whilst the mechanism in young patients generally involves high-impact injuries including road traffic accidents (RTAs). They should stay still for 2–3 seconds while each X-ray is taken so the images are clear. Hip X-rays are done with a child lying on a table. Typically, X-rays of both hips are taken for comparison, even if only one hip is causing symptoms. from the side (lateral view, also known as the frog leg lateral view).from the front (anteroposterior view or AP).This image shows the soft tissues and the bones of the pelvis and hip joints.Īn X-ray technician will take pictures of the hip: In a hip X-ray, an X-ray machine sends a beam of radiation through the pelvic bones and hip joints (where the legs attach to the pelvis), and an image is recorded on a computer or special film. X-rays are commonly done in doctors’ offices, radiology departments, imaging centers, and dentists’ offices. Softer body tissues, such as the skin and muscles, allow the X-ray beams to pass through them. ![]() ![]() Dense body parts, such as bones, block the passage of the X-ray beam through the body. An X-ray is a safe and painless test that uses a small amount of radiation to make an image of bones, organs, and other parts of the body.
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