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Traumatic pelvic and sacral fractures

Case contributed by James Sheldon
Diagnosis certain

Presentation

Pedestrian hit by motor vehicle.

Patient Data

Age: 40 years
Gender: Male

There is diastasis of the pubic symphysis, with the left pubis superiorly displaced and overriding the right pubis. There are comminuted fractures through both sacral ala with elevation of the lateral fragment of the left sacrum and a fracture of the left L5 transverse process. The fractures involve the sacral foraminae bilaterally, and there is also extension into both sacroiliac joints. No associated SI joint dislocation.

These fractures are suggestive of vertical shear mechanism of injury.

There is an associated moderate sized extraperitoneal pelvic hematoma within the left hemi-pelvis with extension of hematoma into the posterior pararenal space of the left retroperitoneum. There is also intramuscular and subcutaneous hematoma within the left groin, and hematoma within the left lower abdominal wall.

Case Discussion

This case demonstrates traumatic pelvic fractures.

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