Medical Disclaimer
The information on this page is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.
Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding a medical condition.
🚨Emergency? If you have severe symptoms, difficulty breathing, or think it's an emergency, call 000 immediately.
Pelvic Ring Injuries (Open Book Fractures)
Anteroposterior compression (APC) pelvic injuries, commonly called 'open book' fractures, occur when a front-to-back crushing force causes the pelvis to spring open like a book—most often from high-energy trauma such as car accidents (side-impact or head-on collisions) or pedestrian strikes, with injury severity ranging from mild pubic symphysis widening (APC I) to complete disruption of the pelvic ring with life-threatening bleeding from torn pelvic veins and arteries (APC III requiring emergency stabilization). In Australia, major trauma centres manage these injuries with immediate resuscitation, temporary external fixation or pelvic binders to control hemorrhage, followed by definitive surgical fixation once the patient is stable—recovery typically takes 3-6 months for walking and 6-12 months for return to normal activities, with outcomes depending on associated injuries to bladder, urethra, nerves, and blood vessels that occur in up to 40-60% of severe cases.
📖What is Pelvic Ring Injuries (Open Book Fractures)?
Anteroposterior compression (APC) pelvic injuries, commonly called 'open book' fractures, occur when a front-to-back crushing force causes the pelvis to spring open like a book—most often from high-energy trauma such as car accidents (side-impact or head-on collisions) or pedestrian strikes, with injury severity ranging from mild pubic symphysis widening (APC I) to complete disruption of the pelvic ring with life-threatening bleeding from torn pelvic veins and arteries (APC III requiring emergency stabilization). In Australia, major trauma centres manage these injuries with immediate resuscitation, temporary external fixation or pelvic binders to control hemorrhage, followed by definitive surgical fixation once the patient is stable—recovery typically takes 3-6 months for walking and 6-12 months for return to normal activities, with outcomes depending on associated injuries to bladder, urethra, nerves, and blood vessels that occur in up to 40-60% of severe cases.
🔬What Causes It?
- High-speed motor vehicle collisions (side-impact most common)
- Pedestrian struck by vehicle
- Motorcycle accidents
- Fall from significant height
- Heavy object crushing pelvis
- Industrial or farming accidents with machinery
⚠️Risk Factors
You may be at higher risk if:
- High-risk occupations (construction, farming, emergency services)
- Motorcycle or bicycle riding on roads
- Older age (increased risk of severe bleeding, poorer bone quality)
- Osteoporosis (can occur with lower-energy trauma)
- Anticoagulant medications (increased bleeding risk)
🛡️Prevention
- ✓Wear seatbelts in vehicles (reduces pelvic injury severity in crashes)
- ✓Use appropriate motorcycle protective gear
- ✓Follow workplace safety protocols for heavy machinery and heights
- ✓Use proper fall protection equipment when working at heights
- ✓Maintain bone health with calcium, vitamin D, and weight-bearing exercise (especially post-menopause)
- ✓Avoid high-risk behaviors (speeding, impaired driving, unsafe work practices)