Duverney fracture
Encyclopedia
Duverney fractures are isolated pelvic fracture
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
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.
, but CT scans are required to fully delineate the fracture and to look for associated fractures involving the pelvic ring.
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.
es or walking frames may be needed until the pain settles.
Open reduction internal fixation 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.
Pelvic fracture
Pelvic fracture is a disruption of the bony structure of the pelvis, including the hip bone, sacrum and coccyx. The most common cause in elderly is a fall, but the most significant fractures involve high-energy forces such as a motor vehicle accident, cycling accidents, or a fall from significant...
s involving only the iliac wing
Ilium (bone)
The ilium is the uppermost and largest bone of the pelvis, 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 name comes from the Latin ,...
. They are caused by direct trauma to the iliac wing, and are generally stable fractures as they do not disrupt the weight bearing
Weight bearing
In orthopedics, weight-bearing is the amount of weight a patient puts on the leg on which surgery has been performed. In general, it is described as a percentage of the body weight, because each leg of a healthy person carries the full body weight when walking, in an alternating fashion.After...
pelvic ring.
The fracture is named after the French
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
surgeon Joseph Guichard Duverney
Guichard Joseph Duverney
Guichard Joseph Duverney or Joseph-Guichard Du Verney was a French anatomist who was a native of Feurs in the province of Forez....
who described the injury in his book Maladies des Os which was published posthumously in 1751.
Diagnosis
Duverney fractures can usually be seen on pelvic X-raysRadiography
Radiography is the use of X-rays to view a non-uniformly composed material such as the human body. By using the physical properties of the ray an image can be developed which displays areas of different density and composition....
, but CT scans are required to fully delineate the fracture and to look for associated fractures involving the pelvic ring.
Complications
Malunion and deformityDeformity
A deformity, dysmorphism, or dysmorphic feature is a major difference in the shape of body part or organ compared to the average shape of that part.Deformity may arise from numerous causes:*A Genetic mutation*Damage to the fetus or uterus...
of the iliac wing can occur. Injury to the internal iliac artery
Internal iliac artery
The internal iliac 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...
can occur, leading to hypovolaemic
Hypovolemia
In physiology and medicine, hypovolemia is a state of decreased blood volume; more specifically, decrease in volume of blood plasma...
shock. Perforation
Gastrointestinal perforation
Gastrointestinal perforation is a complete penetration of the wall of the stomach, small intestine or large bowel, resulting in intestinal contents flowing into the abdominal cavity. Perforation of the intestines results in the potential for bacterial contamination of the abdominal cavity...
of the bowel
Colon (anatomy)
The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...
can occur, leading to sepsis
Sepsis
Sepsis is a potentially deadly medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues...
. Damage to the adjacent nerves of the lumbosacral plexus
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*...
has also been described.
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 crutchCrutch
Crutches are mobility aids used to counter a mobility impairment or an injury that limits walking ability.- Types :There are several different types of crutches:...
es or walking frames may be needed until the pain settles.
Open reduction internal fixation 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.