A woman, approximately 30 years old, is airlifted to your facility after being “found in a ditch,” presumably as a result of a motor vehicle collision. Details are sketchy.
Upon arrival at your facility, she is awake, crying, and complaining of “hurting all over.” She appears to be intoxicated. She is able to give you her name, but not much else in the way of history.
Primary survey shows her vital signs to be: blood pressure, 105/75 mm Hg; heart rate, 102 beats/min; and respiratory rate, 20 breaths/min. She is afebrile. She has a superficial scalp laceration but no other obvious injuries.
You obtain preliminary portable radiographs of the pelvis. What is your impression?
Answer The radiograph demonstrates a mildly displaced fracture of the right iliac wing. In addition, there is moderate diastasis of the pubic symphysis, with the right pubic symphysis being in superior position to the left. Also, a right sacral fracture is present.
The patient was admitted by the trauma service and initially evaluated by the orthopedic trauma team, who planned to take the patient to surgery for subsequent open reduction and internal fixation of these injuries.
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