Pelvic avulsion fracture: Difference between revisions
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*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 | ||
{{Pelvic fracture types}} | |||
==Clinical Features== | ==Clinical Features== | ||
*History of trauma | *History of trauma | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Abdominal trauma DDX}} | |||
{{Hip pain DDX}} | |||
==Evaluation== | ==Evaluation== | ||
[[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]] | |||
*Pelvic X-ray, CT pelvis | *Pelvic X-ray, CT pelvis | ||
*Assess for other injuries and more severe fracture | *Assess for other injuries and more severe fracture | ||
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==Management== | ==Management== | ||
*Do not disrupt pelvic ring, do not usually require surgery | *Do not disrupt pelvic ring, do not usually require surgery | ||
*Analgesia | *[[Analgesia]] | ||
*Crutches, non-weight-bearing status | *Crutches, non-weight-bearing status | ||
*Outpatient orthopedic follow-up | *Outpatient orthopedic follow-up | ||
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==See Also== | ==See Also== | ||
*Pelvic fractures]] | *[[Pelvic fractures]] | ||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Orthopedics]] | |||
Latest revision as of 22:30, 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
Pelvic fracture types
- Acetabular pelvic fractures
- Open book pelvic fracture
- Straddle pelvic fracture
- Pelvic avulsion fracture
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