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Pelvic Fracture, Emergency Medicine

Andrew T. LaFree and Theodore C. Chan Reviewed 06/2017
 


Basics

Description

  • 3% of all bony fractures

  • Pelvis is made up of sacrum and 2 innominate bones:

    • The innominate bones consist of the ilium, ischium, and pubis

  • Boney structures are stabilized by a network o...

Diagnosis

Signs and Symptoms

  • Pain, swelling, ecchymosis, tenderness over hips, groin, perineum, and lower back

  • Often presents with other traumatic injuries including neurologic, intra-abdominal, genitou...

Treatment

Pre-Hospital

  • IV fluid resuscitation as indicated

  • Consider stabilization or immobilization measures for pelvis

Initial Stabilization/Therapy

  • ABCs of trauma care

  • IV fluid resuscitation with blood o...

Follow-Up

Disposition

Admission Criteria

  • Hemodynamic instability, and pelvic hemorrhage to the ICU

  • Type B or C pelvic fracture

  • Acetabular fracture

  • Other related injuries (e.g., genitourinary, intra-abdomin...

Pearls and Pitfalls

  • Pelvic fractures can be a marker for high-energy traumatic mechanism and injury:

    • Assess for underlying abdominal/pelvic injuries including GI, genitourinary, vascular, and neurologi...

Additional Reading

  • American College of Surgeons, Committee on Trauma. Advanced Trauma Life Support for Doctors, 9th ed. Chicago, IL: American College of Surgeons; 2012.

  • Flint  T, Cryer  H. Pelvic Fra...

Codes

ICD9

  • 808.8 Closed unspecified fracture of pelvis

  • 808.41 Closed fracture of ilium

  • 808.42 Closed fracture of ischium

  • 808.2 Closed fracture of pubis

  • 805.6 Closed fracture of sacrum and coccyx without me...

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