Pelvic avulsion fracture

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  • 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

Pelvic fracture types

The skeleton of the human pelvis: 1. Sacrum; 2. Ilium; 3. Ischium; 4. Pubic bone (4a. corpus, 4b. ramus superior, 4c. ramus inferior, 4d. tuberculum pubicum); 5. Pubic symphysis, 6. Acetabulum (of the hip joint), 7. Foramen obturatum, 8. Coccyx/tailbone; Dotted. Linea terminalis of the pelvic brim.
Pelvis anatomy, medial view.
Pelvis anatomy, lateral view.

Clinical Features

  • History of trauma
  • Pain/point tenderness over iliac crests, pubic rami, sacrum, or coccyx

Differential Diagnosis

Abdominal Trauma

Hip pain

Acute Trauma



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
  • Pelvic X-ray, CT pelvis
  • Assess for other injuries and more severe fracture


  • Do not disrupt pelvic ring, do not usually require surgery
  • Analgesia
  • Crutches, non-weight-bearing status
  • Outpatient orthopedic follow-up


  • Discharge if pain controlled and able to safely manage at home with mobility limitations

See Also

External Links