Pelvic avulsion fracture: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Abdominal trauma DDX}} | |||
{{Hip pain DDX}} | |||
==Evaluation== | ==Evaluation== | ||
Revision as of 22:23, 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