2.  19 yo male p/w pelvic
pain and bilateral knee
pain s/p MVC, as a
restrained passenger hs
knees struck the
dashboard.
 T 98.7 P 103 BP 117/62





O2 100%
Gen:
CV: Tachycardic, RR, no
m/r/g
Pulm: Lungs CTA bilat
GU: nml
Ext: bilateral hip pain
with ROM; bilateral
knee contusions
(stable)

5.  Review all cortices of “pretzel”
 If one fracture noted, high index of suspicion for
additional fracture as force to circle affects opposite side
as well
 Width of normal symphysis pubis:
 Children <10 mm
 Adults <5mm
 Consider lesions if greater

6.  ATLS (ABCs, IOM)
 Nondisplaced
 Urgent Orthopedic referral
 Likely non-operative
 Displaced
 Immobilization
 Emergent Orthopedic referral
 Assess for GU trauma

7.  Assess Posterior Pelvis for frx
 Assess symphysis pubis for width
 Concern for possbile Open Book pelvic frx
 Assess GU for trauma
 Possible retrograde urethrogram

8.  http://www.imageinterpretation.co.uk/pelvis.html
 http://www.wheelessonline.com/ortho/12846
 Simon, Robert, and Scott Sherman. Emergency
Orthopedics. New York: McGraw Hill, 2011. 6th Ed.