Question

A patient presents to the emergency department after jumping from a third story and landing on their right foot then falling to the ground. There is pain and crepitus to the right hip when applying gentle downward and medial pressure to the iliac crests. This mechanism of injury is most consistent with what type of pelvic fracture?

Answer 1

The patient's symptoms and the described mechanism of injury indicate an acetabular fracture of the pelvic ring, potentially affecting the stability of the hip joint.

Step-by-step explanation:

The mechanism of injury described, which includes pain and crepitus on applying gentle downward and medial pressure to the iliac crests after jumping from a height and landing on one foot, is consistent with a pelvic fracture known as an acetabular fracture. This type of fracture typically results from high-energy trauma and involves a disruption of the acetabulum, which is part of the hip bone that articulates with the head of the femur to form the hip joint. The presented symptoms and mechanism align with an injury to the pelvic ring, potentially impacting the stability of the hip joint and requiring a thorough evaluation and management plan that might include surgical intervention.

Answer 2

The described mechanism of injury and symptoms suggest an acetabular fracture, common in high-impact trauma such as a fall from height. These fractures often require surgery and are associated with high morbidity and mortality due to complications arising from immobility and surgery.

Step-by-step explanation:

The patient's presentation of pain and crepitus in the right hip upon applying gentle downward and medial pressure to the iliac crests after a jump from a third story landing on the right foot suggests a high-energy mechanism of injury. This type of injury is most consistent with an acetabular fracture, which involves the part of the pelvis that forms the socket of the hip joint. Acetabular fractures are often the result of high-impact trauma, such as a fall from significant height directly onto the feet or legs. The force transmits up the femur to the pelvis, causing a fracture in the region where the femur head articulates with the pelvic bone to form the hip joint. Acetabular fractures can be complex and usually require surgical intervention due to the importance of the hip joint in weight-bearing and mobility.

Hip fractures are associated with high rates of morbidity and mortality, particularly in older individuals or those with osteoporotic bones. A fracture of the femoral neck, for instance, can cause a disruption of the blood supply to the neck or head of the femur, potentially leading to necrosis and the death of bone and cartilage tissue. Surgical treatment followed by a period of immobility can lead to life-threatening complications, such as deep vein thrombosis, pulmonary embolism, pneumonia, infection of pressure ulcers, and urinary tract infections due to catheterization.