Presentation
Young male in a RTA. Clinically unstable pelvis. Assess for surgery.
Patient Data
Pelvic binder in situ. The left innominate bone is shifted posteriorly disrupting the pubic symphyisis. There is marked widening of the ipsilateral left sacroiliac joint.
There is a fracture of the left L5 tranverse process. Small volume pelvic free fluid.
Illustrations from https://radiopaedia.org/cases/pelvic-fracture-diagrams.
Courtesy of Matt Skalski.
Case Discussion
This is a high grade compression fracture of the pelvis from a high energy impact from an RTA.
In the absence of any fractures, one can assume ligamentous injuries have occurred. The vast strength of the pelvic ring has been compromised.
This is an unstable pelvic fracture.