Clinical features
Stable ring injuries
The patient is not severely shocked but has pain on attempting to walk. There is localized tenderness but seldom any damage to pelvic viscera. Plain x-rays reveal the fractures.
Unstable ring injuries
The patient is severely shocked, in great pain and unable to stand. He or she may also be unable to pass urine and there may be blood at the
external meatus. Tenderness is widespread, and attempting to move one or both blades of the ilium is very painful. Clinical assessment for stability is difficult; few patients will allow pulling or pushing to reveal abnormal vertical movement (Olson and Pollack, 1996). One leg may be partly anaesthetic because of sciatic nerve injury.
Haemodynamic instability
High-energy fractures of the pelvis are extremely serious injuries, carrying a great risk of associated visceral damage, intra-abdominal and retroperitoneal haemorrhage, shock, sepsis and ARDS; the mortality rate is considerable. The patient should be repeatedly assessed and re-assessed for signs of blood loss and hypovolaemia. Bear in mind that, although the pelvis may be the main focus of attention, haemorrhage may occur also in areas outside the pelvis.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
viscera /ˈvɪsərə/n. 内脏；内容（viscus的复数）
visceral/ˈvɪsərəl/adj. 内脏的；出于本能的；发自肺腑的；粗俗的
meatus/mɪˈeɪtəs/n. [解剖] 道；[解剖] 口；[昆] 导管
anaesthetic /ˌænəsˈθetɪk/n. 麻醉剂；麻药adj. 麻醉的；麻痹的
sciatic nerve injury坐骨神经损伤
sciatic /saɪˈætɪk/adj. 坐骨的；坐骨神经的；髋部的
Haemodynamic /,hi:məudai'næmik, ,hem-/adj. 血液动力的；血液动力学的
sepsis/ˈsepsɪs/n. 败血症，[医] 脓毒病；腐败作用
the mortality rate死亡率
mortality /mɔːrˈtæləti/n. 死亡数，死亡率；必死性，必死的命运
hypovolaemia[内科] 低血容量症
百度翻译：
临床特征
稳定环损伤
患者没有严重休克，但在尝试行走时感到疼痛。有局部压痛，但很少有盆腔脏器损伤。普通的x光片显示骨折。
不稳定环损伤
病人严重休克，疼痛难忍，无法站立。他或她也可能无法排尿，可能在
外耳道。压痛是普遍的，试图移动一个或两个髂骨刀片是非常痛苦的。稳定性的临床评估是困难的；很少有病人允许拉或推来揭示异常的垂直运动（Olson和Pol lack，1996）。由于坐骨神经损伤，一条腿可能部分麻醉。
血流动力学不稳定
骨盆高能骨折是一种极为严重的损伤，伴有内脏损伤、腹腔内和腹膜后出血、休克、脓毒症和ARDS的危险，死亡率相当高。应反复评估患者是否有失血和低血容量的迹象。请记住，尽管骨盆可能是主要的治疗重点，但骨盆以外的区域也可能发生出血。
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