Advertisement

Pelvic Fractures in Adults: Evidence-Based Emergency Imaging

  • Douglas Watt
  • Ken F. Linnau
  • C. Craig Blackmore
Chapter
Part of the Evidence-Based Imaging book series (Evidence-Based Imag.)

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.

Keywords

Pelvic fractures Acetabular fractures Pelvic ring disruptions Urethral injury Bladder injury Emergency radiology Pelvic trauma Pelvic hemorrhage Evidence-based imaging Emergency imaging 

References

  1. 1.
    Demetriades D, Karaiskakis M, Toutouzas K, et al. J Am Coll Surg. 2002;195:1–10.PubMedCrossRefGoogle Scholar
  2. 2.
    Hauschild O, Strohm PC, Culemann U, et al. J Trauma. 2008;64:449–55.PubMedCrossRefGoogle Scholar
  3. 3.
    Blackmore CC, Jurkovich GJ, Linnau KF, et al. Arch Surg. 2003;138:504–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Pohlemann T, Stengel D, Tosounidis G, et al. Injury. 2011;42:997–1002.PubMedCrossRefGoogle Scholar
  5. 5.
    Prieto-Alhambra D, Avilés FF, Judge A, et al. Osteoporos Int. 2012;23:2797–803.PubMedCrossRefGoogle Scholar
  6. 6.
    Yang NP, Chan CL, Chu D, et al. Biomed Res Int. 2014;2014:878601.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Pohlemann T, Tscherne H, Baumgartel F, et al. Unfallchirurg. 1996;99:160–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Ragnarsson B, Jacobsson B. Acta Orthop Scand. 1992;63:297–300.PubMedCrossRefGoogle Scholar
  9. 9.
    Balogh Z, King KL, Mackay P, et al. J Trauma. 2007;63:1066–73.PubMedCrossRefGoogle Scholar
  10. 10.
    Court-Brown CM, Caesar B. Injury. 2006;37:691–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Gänsslen A, Pohlemann T, Paul C, et al. Injury. 1996;27:A13–20.CrossRefGoogle Scholar
  12. 12.
    Giannoudis PV, Grotz MR, Tzioupis C, et al. J Trauma. 2007;63:875–83.PubMedCrossRefGoogle Scholar
  13. 13.
    Niedzielski KR, Guzikiewicz N, Małecki K, et al. Ortop Traumatol Rehabil. 2013;15(1):41–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Rothenberger DA, Fischer RP, Strate RG, et al. Surgery. 1978;84:356–61.PubMedGoogle Scholar
  15. 15.
    Grotz MR, Allami MK, Harwood P, et al. Injury. 2005;36(1):1–13.PubMedCrossRefGoogle Scholar
  16. 16.
    Schmal H, Markmiller M, Mehlhorn AT, et al. Acta Orthop Belg. 2005;71(1):41–7.PubMedGoogle Scholar
  17. 17.
    Gabbe BJ, de Steiger R, Esser M, et al. Injury. 2011;42(10):985–91.PubMedCrossRefGoogle Scholar
  18. 18.
    Fitzgerald CA, Morse BC, Dente CJ. Am J Surg. 2014;208(6):1083–90.PubMedCrossRefGoogle Scholar
  19. 19.
    Dente CJ, Feliciano DV, Rozycki GS, et al. Am J Surg. 2005;190(6):830–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Birch M, Hargrove R. Eur J Trauma. 2004;2:74–9.CrossRefGoogle Scholar
  21. 21.
    Yoshihara H, Yoneoka D. J Trauma Acute Care Surg. 2014;76(2):380–5.PubMedCrossRefGoogle Scholar
  22. 22.
    Davidson BS, Simmons GT, Williamson PR, et al. J Trauma. 1993;35(1):36–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Mosheiff R, Suchar A, Porat S, et al. Injury. 1999;30:B14–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Ferrera PC, Hill DA. Injury. 1999;30(3):187–90.PubMedCrossRefGoogle Scholar
  25. 25.
    Hanson PB, Milne JC, Chapman MW. J Bone Joint Surg Br. 1991;73(2):325–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Avey G, Blackmore CC, Wessells H, et al. Acad Radiol. 2006;13(5):573–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Morgan DE, Nallamala LK, Kenney PJ, et al. Am J Roentgenol. 2000;174(1):89–95.CrossRefGoogle Scholar
  28. 28.
    Cass AS. Urol Clin North Am. 1989;16(2):267–73.PubMedGoogle Scholar
  29. 29.
    Gomez RG, Ceballos L, Coburn M, et al. BJU Int. 2004;94(1):27–32.PubMedCrossRefGoogle Scholar
  30. 30.
    Palmer JK, Benson GS, Corriere JN Jr. J Urol. 1983;130(4):712–4.PubMedCrossRefGoogle Scholar
  31. 31.
    Basta AM, Blackmore CC, Wessells H. J Urol. 2007;177(2):571–5.PubMedCrossRefGoogle Scholar
  32. 32.
    Andrich DE, Day AC, Mundy AR. BJU Int. 2007;100(3):567–73.PubMedCrossRefGoogle Scholar
  33. 33.
    Chan L, Nade S, Brooks A, et al. Aust N Z J Surg. 1994;64(6):395–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Perry MO, Husmann DA. J Urol. 1992;147(1):139–43.PubMedCrossRefGoogle Scholar
  35. 35.
    Venn SN, Greenwell TJ, Mundy AR. BJU Int. 1999;83(6):626–30.PubMedCrossRefGoogle Scholar
  36. 36.
    Lowe MA, Mason JT, Luna GK, et al. J Urol. 1988;140(3):506–7.PubMedCrossRefGoogle Scholar
  37. 37.
    Watnik NF, Coburn M, Goldberger M. Clin Orthop Relat Res. 1996;329:37–45.CrossRefGoogle Scholar
  38. 38.
    Carter CT, Schafer N. Am J Emerg Med. 1993;11(3):218–20.PubMedCrossRefGoogle Scholar
  39. 39.
    Tile M. J Am Acad Orthop Surg. 1996;4:143–51.PubMedCrossRefGoogle Scholar
  40. 40.
    Burgess AR, Eastridge BJ, Young JW, et al. J Trauma. 1990;30:848–56.PubMedCrossRefGoogle Scholar
  41. 41.
    Judet R, Judet J, Letournel E. J Bone Joint Surg Am. 1964;46-A:1615–38.CrossRefGoogle Scholar
  42. 42.
    Bjurlin MA, Fantus RJ, Mellett MM, et al. J Trauma. 2009;67(5):1033–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Laird A, Keating JF. J Bone Joint Surg Br. 2005;87(7):969–73.PubMedCrossRefGoogle Scholar
  44. 44.
    Zaloshnja E, Miller T, Romano E, et al. Accid Anal Prevent. 2004;36(3):415–27.CrossRefGoogle Scholar
  45. 45.
    Fu CY, Wang SY, Hsu YP, et al. Am J Emerg Med. 2014;32(1):18–23.PubMedCrossRefGoogle Scholar
  46. 46.
    Holstein JH, Culemann U, Pohlemann T. Clin Orthop Relat Res. 2012;470(8):2090–7.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Elzik ME, Dirschl DR, Dahners LE. J Trauma. 2008;65(2):436–41.PubMedCrossRefGoogle Scholar
  48. 48.
    Magnussen RA, Tressler MA, Obremskey WT, et al. J Orthop Trauma. 2007;21(9):603–7.PubMedCrossRefGoogle Scholar
  49. 49.
    Smith W, Williams A, Agudelo J, et al. J Orthop Trauma. 2007;21(1):31–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Pekmezci M, Kandemir U, Toogood P, et al. J Trauma Acute Care Surg. 2013;74(6):1510–5.PubMedCrossRefGoogle Scholar
  51. 51.
    Ohashi K, El-Khoury GY, Abu-Zahra KW, et al. Radiology. 2006;241(2):386–91.PubMedCrossRefGoogle Scholar
  52. 52.
    Sinatra PM, Moed BR. Clin Orthop Relat Res. 2014;472(11):3362–9.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    O’Toole RV, Cox G, Shanmuganathan K, et al. J Orthop Trauma. 2010;24(5):284–90.PubMedCrossRefGoogle Scholar
  54. 54.
    Borrelli J, Goldfarb C, Catalano L, et al. J Orthop Trauma. 2002;16(7):449–56.PubMedCrossRefGoogle Scholar
  55. 55.
    Blackmore CC, Cummings P, Jurkovich GJ, et al. J Trauma. 2006;61:346–52.PubMedCrossRefGoogle Scholar
  56. 56.
    Fu CY, Hsieh CH, Wu SC, et al. Am J Emerg Med. 2013;31(1):42–9.PubMedCrossRefGoogle Scholar
  57. 57.
    Fu CY, Wu SC, Chen RJ, et al. Am J Emerg Med. 2009;27(7):792–6.PubMedCrossRefGoogle Scholar
  58. 58.
    Salim A, Teixeira PG, DuBose J, et al. J Am Coll Surg. 2008;207(5):656–62.PubMedCrossRefGoogle Scholar
  59. 59.
    Niwa T, Takebayashi S, Igari H, et al. Br J Radiol. 2000;73(873):945–50.PubMedCrossRefGoogle Scholar
  60. 60.
    Hamill J, Holden A, Paice R, et al. Aust N Z J Surg. 2000;70(5):338–43.PubMedCrossRefGoogle Scholar
  61. 61.
    O’Sullivan RE, White TO, Keating JF. J Bone Joint Surg Br. 2005;87:530–3.PubMedCrossRefGoogle Scholar
  62. 62.
    Manson T, O’Toole R, Whitney A, et al. J Orthopedics Trauma. 2010;24:603–8.CrossRefGoogle Scholar
  63. 63.
    Osterhoff G, Scheyerer MJ, Fritz Y, et al. Injury. 2014;45(4):742–7.PubMedCrossRefGoogle Scholar
  64. 64.
    Yoon W, Kim JK, Jeong YY, et al. Radiographics. 2004;24(6):1591–605.PubMedCrossRefGoogle Scholar
  65. 65.
    Eastridge BJ, Starr A, Minei JP, et al. J Trauma. 2002;53(3):446–50.PubMedCrossRefGoogle Scholar
  66. 66.
    Starr AJ, Griffin DR, Reinert CM, et al. J Orthop Trauma. 2002;16(8):553–61.PubMedCrossRefGoogle Scholar
  67. 67.
    Sarin EL, Moore JB, Moore EE, et al. J Trauma. 2005;58(5):973–7.PubMedCrossRefGoogle Scholar
  68. 68.
    Jeroukhimov I, Ashkenazi I, Kessel B, et al. Scand J Trauma Resusc Emerg Med. 2009;29:17.Google Scholar
  69. 69.
    Lunsjo K, Tadros A, Hauggaard A, et al. J Trauma. 2007;62:687–91.PubMedCrossRefGoogle Scholar
  70. 70.
    Hallinan JT, Tan CH, Pua U. Clin Radiol. 2014;69(5):529–37.PubMedCrossRefGoogle Scholar
  71. 71.
    Ryan MF, Hamilton PA, Chu P, et al. Can Assoc Radiol J. 2004;55(3):160–9.PubMedGoogle Scholar
  72. 72.
    Pereira SJ, O’Brien DP, Luchette FA, et al. Surgery. 2000;128(4):678–85.PubMedCrossRefGoogle Scholar
  73. 73.
    Stephen DJ, Kreder HJ, Day AC, et al. J Trauma. 1999;47(4):638–42.PubMedCrossRefGoogle Scholar
  74. 74.
    Shanmuganathan K, Mirvis SE, Sover ER. Am J Roentgenol. 1993;161(1):65–9.CrossRefGoogle Scholar
  75. 75.
    Cerva DS Jr, Mirvis SE, Shanmuganathan K, et al. Am J Roentgenol. 1996;166(1):131–5.CrossRefGoogle Scholar
  76. 76.
    Verbeek DO, Zijlstra IA, van der Leij C, et al. J Trauma Acute Care Surg. 2014;76(2):374–9.PubMedCrossRefGoogle Scholar
  77. 77.
    Michailidou M, Velmahos GC, van der Wilden GM, et al. J Trauma Acute Care Surg. 2012;73(3):580–4.PubMedCrossRefGoogle Scholar
  78. 78.
    Anderson SW, Soto JA, Lucey BC, et al. Radiology. 2008;246(2):410–9.PubMedCrossRefGoogle Scholar
  79. 79.
    Fu CY, Wang SY, Liao CH, et al. Am J Emerg Med. 2014;32(10):1220–4.PubMedCrossRefGoogle Scholar
  80. 80.
    Brown CV, Kasotakis G, Wilcox A, et al. Am Surg. 2005;71(9):759–62.PubMedGoogle Scholar
  81. 81.
    Charbit J, Millet I, Martinez O, et al. J Trauma. 2012;73(1):117–25.CrossRefGoogle Scholar
  82. 82.
    Ziran B, Chamberlin E, Franklin S, et al. J. Trauma. 2005;58:533–7.PubMedCrossRefGoogle Scholar
  83. 83.
    Iverson AJ, Morey AF. World J Surg. 2001;25(12):1588–91.PubMedCrossRefGoogle Scholar
  84. 84.
    Udekwu PO, Gurkin B, Oller DW. Am Surg. 1996;62(1):56–9.PubMedGoogle Scholar
  85. 85.
    Belis JA, Recht KA, Milam DF. J Urol. 1979;122(3):412–4.PubMedCrossRefGoogle Scholar
  86. 86.
    Muhammad I, Mabogunje OA. Injury. 1988;19(5):357–9.PubMedCrossRefGoogle Scholar
  87. 87.
    Mee SL, McAninch JW, Federle MP. J Urol. 1987;137(2):207–9.PubMedCrossRefGoogle Scholar
  88. 88.
    Horstman WG, McClennan BL, Heiken JP. Urol Radiol. 1991;12(4):188–93.PubMedGoogle Scholar
  89. 89.
    Koraitim MM. Urology. 2013;81(5):1081–5.PubMedCrossRefGoogle Scholar
  90. 90.
    Koraitim MM. J Urol. 1999;161(5):1433–41.PubMedCrossRefGoogle Scholar
  91. 91.
    Devine PC, Devine CJ Jr. Urology. 1982;20(5):467–70.PubMedCrossRefGoogle Scholar
  92. 92.
    Pokorny M, Pontes JE, Pierce JM Jr. J Urol. 1979;121(4):455–7.PubMedCrossRefGoogle Scholar
  93. 93.
    Aihara R, Blansfield JS, Millham FH, et al. J Trauma. 2002;52(2):205–8.PubMedGoogle Scholar
  94. 94.
    Chan DP, Abujudeh HH, Cushing GL Jr, et al. Am J Roentgenol. 2006;187(5):1296–302.CrossRefGoogle Scholar
  95. 95.
    Deck AJ, Shaves S, Talner L, et al. World J Surg. 2001;25(12):1592–6.PubMedCrossRefGoogle Scholar
  96. 96.
    Pao DM, Ellis JH, Cohan RH, et al. Acad Radiol. 2000;7(5):317–24.PubMedCrossRefGoogle Scholar
  97. 97.
    Rehm CG, Mure AJ, O’Malley KF, et al. Ann Emerg Med. 1991;20(8):845–7.PubMedCrossRefGoogle Scholar
  98. 98.
    Spencer Netto FA, Hamilton P, Kodama R, et al. J Am Coll Surg. 2008;206(2):322–7.PubMedCrossRefGoogle Scholar
  99. 99.
    Lückhoff C, Mitra B, Cameron PA, et al. Injury. 2011;42(9):913–6.PubMedCrossRefGoogle Scholar
  100. 100.
    Alwaal A, Zaid UB, Blaschko SD, et al. Arab J Urol. 2015;13(1):2–6.PubMedCrossRefGoogle Scholar
  101. 101.
    Black PC, Miller EA, Porter JR, et al. J Urol. 2006;175(6):2140–4.PubMedCrossRefGoogle Scholar
  102. 102.
    Batislam E, Ateş Y, Germiyanoĝlu C, et al. J Trauma. 1997;42(2):285–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Douglas Watt
    • 1
  • Ken F. Linnau
    • 2
  • C. Craig Blackmore
    • 3
  1. 1.Department of RadiologyVirginia Mason Medical CenterSeattleUSA
  2. 2.Department of RadiologyHarborview Medical Center, University of WashingtonSeattleUSA
  3. 3.Department of RadiologyCenter for Health Care Improvement Science, Virginia Mason Medical CenterSeattleUSA

Personalised recommendations