Pelvic avulsion fracture

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

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

Clinical Features

• History of trauma
• Pain/point tenderness over iliac crests, pubic rami, sacrum, or coccyx

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

See Also

• Pelvic fractures