Pelvic avulsion fracture: Difference between revisions
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==Background== | ==Background== | ||
[[File:PelvicAvulsion.png|thumb|Avulsion fracture of: (1) Iliac wing (Duverney fracture) (2) Superior pubic ramus (3) Inferior pubic ramus (4) Transverse sacral (5) Coccyx fracture. (6) Anterior superior iliac spine (7) Anterior inferior iliac spine (8) Ischial tuberosity]] | |||
*Isolated, closed avulsion fracture of pelvis or single-bone | *Isolated, closed avulsion fracture of pelvis or single-bone | ||
*Trauma may be very minor (e.g. fall from seated) in elderly or those with weakened bones | *Trauma may be very minor (e.g. fall from seated) in elderly or those with weakened bones | ||
*Sports-related avulsion fractures are most common pelvic injuries in children | *Sports-related avulsion fractures are most common pelvic injuries in children | ||
==Clinical Features== | ==Clinical Features== | ||
*History of trauma | *History of trauma | ||
Revision as of 22:25, 17 March 2021
Background
- Isolated, closed avulsion fracture of pelvis or single-bone
- Trauma may be very minor (e.g. fall from seated) in elderly or those with weakened bones
- Sports-related avulsion fractures are most common pelvic injuries in children
Clinical Features
- History of trauma
- Pain/point tenderness over iliac crests, pubic rami, sacrum, or coccyx
Differential Diagnosis
Abdominal Trauma
- Abdominal compartment syndrome
- Diaphragmatic trauma
- Duodenal hematoma
- Genitourinary trauma
- Liver trauma
- Pelvic fractures
- Retroperitoneal hemorrhage
- Renal trauma
- Splenic trauma
- Trauma in pregnancy
- Ureter trauma
Hip pain
Acute Trauma
- Femur fracture
- Proximal
- Intracapsular
- Extracapsular
- Shaft
- Mid-shaft femur fracture (all subtrochanteric)
- Proximal
- Hip dislocation
- Pelvic fractures
Chronic/Atraumatic
- Hip bursitis
- Psoas abscess
- Piriformis syndrome
- Meralgia paresthetica
- Septic arthritis
- Obturator nerve entrapment
- Avascular necrosis of hip
Evaluation
- Pelvic X-ray, CT pelvis
- Assess for other injuries and more severe fracture
Management
- Do not disrupt pelvic ring, do not usually require surgery
- Analgesia
- Crutches, non-weight-bearing status
- Outpatient orthopedic follow-up
Disposition
- Discharge if pain controlled and able to safely manage at home with mobility limitations