Skip to main content
SpringerLink
Log in

Pelvic Fractures in Adults: Evidence-Based Emergency Imaging

  • Chapter
  • First Online:
Evidence-Based Emergency Imaging

Part of the book series: Evidence-Based Imaging ((Evidence-Based Imag.))

  • 1149 Accesses

Abstract

This chapter examines the existing medical literature pertaining to emergent radiologic evaluation of pelvic trauma with suspected pelvic fractures. The primary goals of imaging are to characterize pelvic fractures, in order to guide treatment and attempt to predict high-morbidity complications. The evidence regarding how to optimally image patients with suspected pelvic fractures as well as fracture classification systems, imaging cases studies, and suggested imaging protocols are presented in the chapter. Additionally, the imaging and clinical predictors of major pelvic hemorrhage, bladder rupture, and urethral injury are summarized and weighted based on strength of evidence.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Demetriades D, Karaiskakis M, Toutouzas K, et al. J Am Coll Surg. 2002;195:1–10.

    PubMed  Google Scholar 

  2. Hauschild O, Strohm PC, Culemann U, et al. J Trauma. 2008;64:449–55.

    PubMed  Google Scholar 

  3. Blackmore CC, Jurkovich GJ, Linnau KF, et al. Arch Surg. 2003;138:504–8.

    PubMed  Google Scholar 

  4. Pohlemann T, Stengel D, Tosounidis G, et al. Injury. 2011;42:997–1002.

    PubMed  Google Scholar 

  5. Prieto-Alhambra D, Avilés FF, Judge A, et al. Osteoporos Int. 2012;23:2797–803.

    CAS  PubMed  Google Scholar 

  6. Yang NP, Chan CL, Chu D, et al. Biomed Res Int. 2014;2014:878601.

    PubMed  PubMed Central  Google Scholar 

  7. Pohlemann T, Tscherne H, Baumgartel F, et al. Unfallchirurg. 1996;99:160–7.

    CAS  PubMed  Google Scholar 

  8. Ragnarsson B, Jacobsson B. Acta Orthop Scand. 1992;63:297–300.

    CAS  PubMed  Google Scholar 

  9. Balogh Z, King KL, Mackay P, et al. J Trauma. 2007;63:1066–73.

    PubMed  Google Scholar 

  10. Court-Brown CM, Caesar B. Injury. 2006;37:691–7.

    PubMed  Google Scholar 

  11. Gänsslen A, Pohlemann T, Paul C, et al. Injury. 1996;27:A13–20.

    Google Scholar 

  12. Giannoudis PV, Grotz MR, Tzioupis C, et al. J Trauma. 2007;63:875–83.

    PubMed  Google Scholar 

  13. Niedzielski KR, Guzikiewicz N, Małecki K, et al. Ortop Traumatol Rehabil. 2013;15(1):41–8.

    PubMed  Google Scholar 

  14. Rothenberger DA, Fischer RP, Strate RG, et al. Surgery. 1978;84:356–61.

    CAS  PubMed  Google Scholar 

  15. Grotz MR, Allami MK, Harwood P, et al. Injury. 2005;36(1):1–13.

    CAS  PubMed  Google Scholar 

  16. Schmal H, Markmiller M, Mehlhorn AT, et al. Acta Orthop Belg. 2005;71(1):41–7.

    PubMed  Google Scholar 

  17. Gabbe BJ, de Steiger R, Esser M, et al. Injury. 2011;42(10):985–91.

    PubMed  Google Scholar 

  18. Fitzgerald CA, Morse BC, Dente CJ. Am J Surg. 2014;208(6):1083–90.

    PubMed  Google Scholar 

  19. Dente CJ, Feliciano DV, Rozycki GS, et al. Am J Surg. 2005;190(6):830–5.

    PubMed  Google Scholar 

  20. Birch M, Hargrove R. Eur J Trauma. 2004;2:74–9.

    Google Scholar 

  21. Yoshihara H, Yoneoka D. J Trauma Acute Care Surg. 2014;76(2):380–5.

    PubMed  Google Scholar 

  22. Davidson BS, Simmons GT, Williamson PR, et al. J Trauma. 1993;35(1):36–9.

    CAS  PubMed  Google Scholar 

  23. Mosheiff R, Suchar A, Porat S, et al. Injury. 1999;30:B14–8.

    PubMed  Google Scholar 

  24. Ferrera PC, Hill DA. Injury. 1999;30(3):187–90.

    CAS  PubMed  Google Scholar 

  25. Hanson PB, Milne JC, Chapman MW. J Bone Joint Surg Br. 1991;73(2):325–9.

    CAS  PubMed  Google Scholar 

  26. Avey G, Blackmore CC, Wessells H, et al. Acad Radiol. 2006;13(5):573–9.

    PubMed  Google Scholar 

  27. Morgan DE, Nallamala LK, Kenney PJ, et al. Am J Roentgenol. 2000;174(1):89–95.

    CAS  Google Scholar 

  28. Cass AS. Urol Clin North Am. 1989;16(2):267–73.

    CAS  PubMed  Google Scholar 

  29. Gomez RG, Ceballos L, Coburn M, et al. BJU Int. 2004;94(1):27–32.

    PubMed  Google Scholar 

  30. Palmer JK, Benson GS, Corriere JN Jr. J Urol. 1983;130(4):712–4.

    CAS  PubMed  Google Scholar 

  31. Basta AM, Blackmore CC, Wessells H. J Urol. 2007;177(2):571–5.

    PubMed  Google Scholar 

  32. Andrich DE, Day AC, Mundy AR. BJU Int. 2007;100(3):567–73.

    PubMed  Google Scholar 

  33. Chan L, Nade S, Brooks A, et al. Aust N Z J Surg. 1994;64(6):395–9.

    CAS  PubMed  Google Scholar 

  34. Perry MO, Husmann DA. J Urol. 1992;147(1):139–43.

    CAS  PubMed  Google Scholar 

  35. Venn SN, Greenwell TJ, Mundy AR. BJU Int. 1999;83(6):626–30.

    CAS  PubMed  Google Scholar 

  36. Lowe MA, Mason JT, Luna GK, et al. J Urol. 1988;140(3):506–7.

    CAS  PubMed  Google Scholar 

  37. Watnik NF, Coburn M, Goldberger M. Clin Orthop Relat Res. 1996;329:37–45.

    Google Scholar 

  38. Carter CT, Schafer N. Am J Emerg Med. 1993;11(3):218–20.

    CAS  PubMed  Google Scholar 

  39. Tile M. J Am Acad Orthop Surg. 1996;4:143–51.

    CAS  PubMed  Google Scholar 

  40. Burgess AR, Eastridge BJ, Young JW, et al. J Trauma. 1990;30:848–56.

    CAS  PubMed  Google Scholar 

  41. Judet R, Judet J, Letournel E. J Bone Joint Surg Am. 1964;46-A:1615–38.

    Google Scholar 

  42. Bjurlin MA, Fantus RJ, Mellett MM, et al. J Trauma. 2009;67(5):1033–9.

    PubMed  Google Scholar 

  43. Laird A, Keating JF. J Bone Joint Surg Br. 2005;87(7):969–73.

    CAS  PubMed  Google Scholar 

  44. Zaloshnja E, Miller T, Romano E, et al. Accid Anal Prevent. 2004;36(3):415–27.

    Google Scholar 

  45. Fu CY, Wang SY, Hsu YP, et al. Am J Emerg Med. 2014;32(1):18–23.

    PubMed  Google Scholar 

  46. Holstein JH, Culemann U, Pohlemann T. Clin Orthop Relat Res. 2012;470(8):2090–7.

    PubMed  PubMed Central  Google Scholar 

  47. Elzik ME, Dirschl DR, Dahners LE. J Trauma. 2008;65(2):436–41.

    PubMed  Google Scholar 

  48. Magnussen RA, Tressler MA, Obremskey WT, et al. J Orthop Trauma. 2007;21(9):603–7.

    PubMed  Google Scholar 

  49. Smith W, Williams A, Agudelo J, et al. J Orthop Trauma. 2007;21(1):31–7.

    PubMed  Google Scholar 

  50. Pekmezci M, Kandemir U, Toogood P, et al. J Trauma Acute Care Surg. 2013;74(6):1510–5.

    PubMed  Google Scholar 

  51. Ohashi K, El-Khoury GY, Abu-Zahra KW, et al. Radiology. 2006;241(2):386–91.

    PubMed  Google Scholar 

  52. Sinatra PM, Moed BR. Clin Orthop Relat Res. 2014;472(11):3362–9.

    PubMed  PubMed Central  Google Scholar 

  53. O’Toole RV, Cox G, Shanmuganathan K, et al. J Orthop Trauma. 2010;24(5):284–90.

    PubMed  Google Scholar 

  54. Borrelli J, Goldfarb C, Catalano L, et al. J Orthop Trauma. 2002;16(7):449–56.

    PubMed  Google Scholar 

  55. Blackmore CC, Cummings P, Jurkovich GJ, et al. J Trauma. 2006;61:346–52.

    PubMed  Google Scholar 

  56. Fu CY, Hsieh CH, Wu SC, et al. Am J Emerg Med. 2013;31(1):42–9.

    PubMed  Google Scholar 

  57. Fu CY, Wu SC, Chen RJ, et al. Am J Emerg Med. 2009;27(7):792–6.

    PubMed  Google Scholar 

  58. Salim A, Teixeira PG, DuBose J, et al. J Am Coll Surg. 2008;207(5):656–62.

    PubMed  Google Scholar 

  59. Niwa T, Takebayashi S, Igari H, et al. Br J Radiol. 2000;73(873):945–50.

    CAS  PubMed  Google Scholar 

  60. Hamill J, Holden A, Paice R, et al. Aust N Z J Surg. 2000;70(5):338–43.

    CAS  PubMed  Google Scholar 

  61. O’Sullivan RE, White TO, Keating JF. J Bone Joint Surg Br. 2005;87:530–3.

    PubMed  Google Scholar 

  62. Manson T, O’Toole R, Whitney A, et al. J Orthopedics Trauma. 2010;24:603–8.

    Google Scholar 

  63. Osterhoff G, Scheyerer MJ, Fritz Y, et al. Injury. 2014;45(4):742–7.

    PubMed  Google Scholar 

  64. Yoon W, Kim JK, Jeong YY, et al. Radiographics. 2004;24(6):1591–605.

    PubMed  Google Scholar 

  65. Eastridge BJ, Starr A, Minei JP, et al. J Trauma. 2002;53(3):446–50.

    PubMed  Google Scholar 

  66. Starr AJ, Griffin DR, Reinert CM, et al. J Orthop Trauma. 2002;16(8):553–61.

    PubMed  Google Scholar 

  67. Sarin EL, Moore JB, Moore EE, et al. J Trauma. 2005;58(5):973–7.

    PubMed  Google Scholar 

  68. Jeroukhimov I, Ashkenazi I, Kessel B, et al. Scand J Trauma Resusc Emerg Med. 2009;29:17.

    Google Scholar 

  69. Lunsjo K, Tadros A, Hauggaard A, et al. J Trauma. 2007;62:687–91.

    PubMed  Google Scholar 

  70. Hallinan JT, Tan CH, Pua U. Clin Radiol. 2014;69(5):529–37.

    CAS  PubMed  Google Scholar 

  71. Ryan MF, Hamilton PA, Chu P, et al. Can Assoc Radiol J. 2004;55(3):160–9.

    PubMed  Google Scholar 

  72. Pereira SJ, O’Brien DP, Luchette FA, et al. Surgery. 2000;128(4):678–85.

    CAS  PubMed  Google Scholar 

  73. Stephen DJ, Kreder HJ, Day AC, et al. J Trauma. 1999;47(4):638–42.

    CAS  PubMed  Google Scholar 

  74. Shanmuganathan K, Mirvis SE, Sover ER. Am J Roentgenol. 1993;161(1):65–9.

    CAS  Google Scholar 

  75. Cerva DS Jr, Mirvis SE, Shanmuganathan K, et al. Am J Roentgenol. 1996;166(1):131–5.

    Google Scholar 

  76. Verbeek DO, Zijlstra IA, van der Leij C, et al. J Trauma Acute Care Surg. 2014;76(2):374–9.

    PubMed  Google Scholar 

  77. Michailidou M, Velmahos GC, van der Wilden GM, et al. J Trauma Acute Care Surg. 2012;73(3):580–4.

    PubMed  Google Scholar 

  78. Anderson SW, Soto JA, Lucey BC, et al. Radiology. 2008;246(2):410–9.

    PubMed  Google Scholar 

  79. Fu CY, Wang SY, Liao CH, et al. Am J Emerg Med. 2014;32(10):1220–4.

    PubMed  Google Scholar 

  80. Brown CV, Kasotakis G, Wilcox A, et al. Am Surg. 2005;71(9):759–62.

    PubMed  Google Scholar 

  81. Charbit J, Millet I, Martinez O, et al. J Trauma. 2012;73(1):117–25.

    Google Scholar 

  82. Ziran B, Chamberlin E, Franklin S, et al. J. Trauma. 2005;58:533–7.

    PubMed  Google Scholar 

  83. Iverson AJ, Morey AF. World J Surg. 2001;25(12):1588–91.

    CAS  PubMed  Google Scholar 

  84. Udekwu PO, Gurkin B, Oller DW. Am Surg. 1996;62(1):56–9.

    CAS  PubMed  Google Scholar 

  85. Belis JA, Recht KA, Milam DF. J Urol. 1979;122(3):412–4.

    CAS  PubMed  Google Scholar 

  86. Muhammad I, Mabogunje OA. Injury. 1988;19(5):357–9.

    CAS  PubMed  Google Scholar 

  87. Mee SL, McAninch JW, Federle MP. J Urol. 1987;137(2):207–9.

    CAS  PubMed  Google Scholar 

  88. Horstman WG, McClennan BL, Heiken JP. Urol Radiol. 1991;12(4):188–93.

    CAS  PubMed  Google Scholar 

  89. Koraitim MM. Urology. 2013;81(5):1081–5.

    PubMed  Google Scholar 

  90. Koraitim MM. J Urol. 1999;161(5):1433–41.

    CAS  PubMed  Google Scholar 

  91. Devine PC, Devine CJ Jr. Urology. 1982;20(5):467–70.

    CAS  PubMed  Google Scholar 

  92. Pokorny M, Pontes JE, Pierce JM Jr. J Urol. 1979;121(4):455–7.

    CAS  PubMed  Google Scholar 

  93. Aihara R, Blansfield JS, Millham FH, et al. J Trauma. 2002;52(2):205–8.

    PubMed  Google Scholar 

  94. Chan DP, Abujudeh HH, Cushing GL Jr, et al. Am J Roentgenol. 2006;187(5):1296–302.

    Google Scholar 

  95. Deck AJ, Shaves S, Talner L, et al. World J Surg. 2001;25(12):1592–6.

    CAS  PubMed  Google Scholar 

  96. Pao DM, Ellis JH, Cohan RH, et al. Acad Radiol. 2000;7(5):317–24.

    CAS  PubMed  Google Scholar 

  97. Rehm CG, Mure AJ, O’Malley KF, et al. Ann Emerg Med. 1991;20(8):845–7.

    CAS  PubMed  Google Scholar 

  98. Spencer Netto FA, Hamilton P, Kodama R, et al. J Am Coll Surg. 2008;206(2):322–7.

    PubMed  Google Scholar 

  99. Lückhoff C, Mitra B, Cameron PA, et al. Injury. 2011;42(9):913–6.

    PubMed  Google Scholar 

  100. Alwaal A, Zaid UB, Blaschko SD, et al. Arab J Urol. 2015;13(1):2–6.

    PubMed  Google Scholar 

  101. Black PC, Miller EA, Porter JR, et al. J Urol. 2006;175(6):2140–4.

    PubMed  Google Scholar 

  102. Batislam E, Ateş Y, Germiyanoĝlu C, et al. J Trauma. 1997;42(2):285–7.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Virginia Mason Medical Center, Seattle, WA, USA

    Douglas Watt

  2. Department of Radiology, Harborview Medical Center, University of Washington, Seattle, WA, USA

    Ken F. Linnau

  3. Department of Radiology, Center for Health Care Improvement Science, Virginia Mason Medical Center, Seattle, WA, USA

    C. Craig Blackmore

Authors
  1. Douglas Watt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ken F. Linnau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Craig Blackmore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Craig Blackmore .

Editor information

Editors and Affiliations

  1. Department of Radiology, Division of Cardio-Thoracic Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Aine Kelly

  2. Department of Radiology, Division of Cardio-Thoracic Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Paul Cronin

  3. Department of Diagnostic, Interventional, and Pediatric Radiology Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland

    Stefan Puig

  4. Department of Radiology, University of Kentucky Children’s Hospital, Lexington, KY, USA

    Kimberly E. Applegate

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Watt, D., Linnau, K.F., Blackmore, C.C. (2018). Pelvic Fractures in Adults: Evidence-Based Emergency Imaging. In: Kelly, A., Cronin, P., Puig, S., Applegate, K. (eds) Evidence-Based Emergency Imaging. Evidence-Based Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-67066-9_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-67066-9_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67064-5

  • Online ISBN: 978-3-319-67066-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation