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Surgical anatomy
The pelvic ring is made up of the two innominate bones and the sacrum, articulating in front at the symphysis pubis (the anterior or pubic bridge) and posteriorly at the sacroiliac joints (the posterior or sacroiliac bridge). This basin-like structure transmits weight from the trunk to the lower limbs and provides protection for the pelvic viscera, vessels and nerves.
The stability of the pelvic ring depends upon the rigidity of the bony parts and the integrity of the strong ligaments that bind the three segments together across the symphysis pubis and the sacroiliac joints. The strongest and most important of the tethering ligaments are the sacroiliac and iliolumbar ligaments; these are supplemented by the sacrotuberous and sacrospinous ligaments and the ligaments of the symphysis pubis. As long as the bony ring and the ligaments are intact, load-bearing is unimpaired.
The major branches of the common iliac arteries arise within the pelvis between the level of the sacroiliac joint and the greater sciatic notch. With their accompanying veins they are particularly vulnerable in fractures through the posterior part of the pelvic ring. The nerves of the lumbar and sacral plexuses, likewise, are at risk with posterior pelvic injuries.
The bladder lies behind the symphysis pubis. The trigone is held in position by the lateral ligaments of the bladder and, in the male, by the prostate. The prostate lies between the bladder and the pelvic floor. It is held laterally by the medial fibres of the levator ani, whilst anteriorly it is firmly attached to the pubic bones by the puboprostatic ligament. In the female the trigone is attached also to the cervix and the anterior vaginal fornix. The urethra is held by both the pelvic floor muscles and the pubourethral ligament. Consequently in females the urethra is much more mobile and less prone to injury.
In severe pelvic injuries the membranous urethra is damaged when the prostate is forced backwards whilst the urethra remains static. When the puboprostatic ligament is torn, the prostate and base of the bladder can become grossly dislocated from the membranous urethra.
The pelvic colon, with its mesentery, is a mobile structure and therefore not readily injured. However, the rectum and anal canal are more firmly tethered to the urogenital structures and the muscular floor of the pelvis and are therefore vulnerable in pelvic fractures.
---from 《Apley’s System of Orthopaedics and Fractures》
重點詞彙整理：
innominate /ɪˈnɑːmənɪt/adj. 無名的；匿名的
sacrum /ˈseɪkrəm,ˈsækrəm/n. [解剖] 骶骨
symphysis pubis 恥骨聯合
symphysis /ˈsɪmfəsɪs/n. [解剖] 聯合；合生；骨的癒合
pubis /ˈpjuːbɪs/n. 恥骨；前胸側部
pubic /ˈpjuːbɪk/adj. 恥骨的；陰毛的；陰部的
sacroiliac /ˌsækroʊˈɪliˌæk; ˌseɪkroʊˈɪliˌæk/n. 骶骼骨關節adj. 骶髂的；骶髂關節的
basin /ˈbeɪsn/n. 水池；流域；盆地；盆
trunk /trʌŋk/n. 樹幹；軀幹；象鼻；
pelvic/ˈpelvɪk/adj. 骨盆的
viscera /ˈvɪsərə/n. 內臟；內容（viscus的複數）
rigidity /rɪˈdʒɪdəti/n. [物] 硬度，[力] 剛性；嚴格，刻板；僵化；堅硬
integrity /ɪnˈteɡrəti/n. 完整；正直；誠實；廉正
unimpaired /ˌʌnɪmˈperd/adj. 未受損傷的；沒有削弱的，未減少的
the greater sciatic notch.坐骨大切跡。
sciatic /saɪˈætɪk/adj. 坐骨的；坐骨神經的；髖部的
notch. /nɑːtʃ/n. 刻痕，凹口；等級；峽谷vt. 贏得；用刻痕計算；在…上刻凹痕
sacral plexuses,骶叢
sacral adj. 骶骨的；聖禮的；祭典的
plexuses/ˈpleksəs/n. （血管、淋巴管、神經等的）[解剖] 叢
trigone /trɪ'gəʊn, 'trʌɪ-/n. 膀胱三角區；三角形體；三稜
prostate /ˈprɑːsteɪt/adj. 前列腺的n. 前列腺
levator ani, 肛提肌
cervix/ˈsɜːrvɪks/n. 子宮頸；頸部
the anterior vaginal fornix.陰道前穹隆
urethra /jʊˈriːθrə/n. [解剖] 尿道
membranous /ˈmembrənəs/adj. 膜的；膜性的；膜狀的
static /ˈstætɪk/n. 靜電；靜電幹擾adj. 靜態的；靜電的；靜力的
grossly /ˈɡroʊsli/adv. 很；非常
mesentery, /ˈmesənˌterɪ/n. [解剖] 腸繫膜
rectum /ˈrektəm/n. 直腸
anal canal 肛管
百度翻譯：
外科解剖學
骨盆環由兩塊無名骨和骶骨組成，在恥骨前關節（前橋或恥骨橋）前關節，後關節在骶髂關節（後骶髂橋）處。這種盆狀結構將重量從軀幹傳遞到下肢，並為盆腔臟器、血管和神經提供保護。
骨盆環的穩定性取決於骨部件的剛性和將三個節段連接在恥骨聯合和骶髂關節的堅固韌帶的完整性。最堅固和最重要的栓系韌帶是骶髂韌帶和髂腰韌帶；這些韌帶由骶管韌帶和骶棘韌帶以及恥骨聯合韌帶補充。只要骨環和韌帶完好無損，承重就不會受損。
髂總動脈的主要分支出現在骨盆內骶髂關節和坐骨大切跡之間。伴隨著靜脈，在骨盆環後部骨折時尤其脆弱。同樣，腰骶神經叢也有後骨盆損傷的危險。
膀胱位於恥骨聯合後面。三角區由膀胱外側韌帶固定，男性則由前列腺固定。前列腺位於膀胱和盆底之間。它由肛提肌的內側纖維側向固定，而在前方則由恥骨支撐韌帶牢固地附著在恥骨上。女性的三角也附著在子宮頸和陰道前穹窿。尿道由盆底肌肉和恥骨尿道韌帶共同支撐。因此，女性尿道更容易受傷。
在嚴重的骨盆損傷中，當前列腺被迫向後移動而尿道保持靜止時，膜性尿道會受損。當恥骨支撐韌帶撕裂時，前列腺和膀胱底部會從尿道膜上嚴重脫臼。
盆腔結腸及其腸繫膜是一個可移動的結構，因此不易受傷。然而，直腸和肛管與泌尿生殖結構和骨盆肌層的聯繫更為牢固，因此在骨盆骨折中很容易受傷。
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