The bony pelvis consists of the ilium, ishium, and pubis, which form an anatomic ring with the sacrum (Mechem, 2013). The pelvis also includes the pelvic girdle – right and left hipbones, and the coccyx. Each hipbone is formed by three bones fused to one another to form a single bone. The ilium is the superior, the ishium is inferior and posterior, and the pubis is inferior and anterior. The hipbones join anteriorly at the symphysis pubis, or pubic symphysis. Posteriorly, each hipbone joins the sacrum at the sacroiliac joint (McGraw-Hill). Soft tissues surrounding the pelvis are the urinary bladder, uterus, bowel and sacrospinous ligaments (Kalman).
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Ensure no rotation of the pelvis while centering the IR to the projected central ray. The central ray for the inlet projection is forty degrees caudal to the level of ASIS. The central ray for the outlet projection is twenty to thirty-five degrees cephalad for a male patient and thirty to forty-five degrees cephalad for a female patient while centering one to two inches inferior to symphysis pubis or greater trochanter. Suspend respiration during the exposure with a source to image distance of forty to forty-four inches (Bontrager, 2014).
For the Lillienfield method, the patient is seated erect on the table, with the knees flexed slightly and the feet resting on the table top. A supporting structure should be placed behind the knees. The midsagittal plane of the patient’s body should be centered about the midline of the table. Ensure no rotation of the pelvis. The arms should be extended behind the patient with the hands placed on the table top, supporting the torso in a position approximately fifty degrees from vertical. A supporting structure should be placed behind the lower back. The central ray is directed perpendicularly to the IR and centered to a point one and a half inches superior to the symphysis pubis. Suspend respiration during the exposure (Baert, 2006).
For the AP projection, the patient is in a supine position with the pelvis centered to the centerline with the legs extended. Both feet, knees, and legs equally rotated internally fifteen degrees (unless any fractures of the hips are involved). Ensure no rotation of the pelvis while centering the IR to the central ray. The central ray should be perpendicular and midway between ASISs and symphysis pubis. Suspend respiration during the exposure with a source to image distance of forty to forty-four inches (Bontrager, 2014).
Pelvic fractures are most commonly described using one of two classification systems. The Tile classification system is based on the...