Straddle pelvic fracture


  • Also known as "Four-pillar" injury[1]
  • Involves fractures of both pubic rami bilaterally
  • Causes a "butterfly segment" containing the pubic symphysis

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

  • Often associated with
    • posterior arch injuries
    • genitourinary injuries

Differential Diagnosis

Abdominal Trauma

Hip pain

Acute Trauma



  • Xray
  • CT better evaluates posterior arch


  • Orthopedic surgery


See Also

External Links


  1. Rosen's Emergency Medicine. Philadelphia, PA. 2014.