Pelvis Case #1

H&P25 yo male brought

in as a trauma alert in an MVC. EMS reports a head on collision with intrusion into the passenger cabin. The patient complains of severe right hip pain.

VS: P 113 RR 22 BP 123/75

Gen: Anxious, appears to be in pain. GCS 15

Chest/Abd: Non-tender to palpation

Extrem: Right hip deformity and tenderness to palpation

Image

Right Acetabular Fracture with Posterior Dislocation of the hip

Follow basic ATLS protocolPain management and eval for other possible

injuriesEarly Orthopedics consultAdmit for operative repair

ED Management

Acetabular fractures are most often associated with high velocity trauma.

Important to keep in mind that acetabular fractures can be associated with other injuries

Can also occur in the elderly in seemingly minor injuries

Pain is often elicited by axial loadingOften missed on plain films, diagnosed after

CT when elderly patient has pain/inability to walk on reassessment

Pearls

Other Images

Thacker, M et al. “Acetabulum Fractures”. Emedicine.com. 7/2009.

Thornton, D et al. “Acetabulum Fracture imaging”. Emedicine.com 5/2011

Tininalli, J et al. “Emergency Medicine: A Comprehensive Study Guide”. 6th ed. 2003

Wheeless, C. “Fracutures of the Acetabulum”. Wheelessonline.com. 5/2011

References