ESTABILISHED STANDARD PREHOSPITAL TRANSPORT PROTOCOL AND EMERGENCY DEPARTMENT MANAGEMENT ALGORITHMS 11% PREALGORITHM 7% POST ALGORITHM

1-MOTORCYCLE COLLISION 2-CAR VS PEDESTRIAN 3-FALL OVER 4.6 M 4-LATERAL IMPACT 5-MVC WITH VEHICLE INCOMPATIBILITY HIGH ENERGY TRAUMA

MEN > WOMEN 33YEARS

SUSPICION OF PELVIC FRACTURE 1-MECHANISM OF FRACTURE EMERGENCY MEDICAL PROFESSTIONAL INFORMATION 2-PATIONT PRESENTATION 3-PHYSICAL EXAM

1- SHORTENING OF LOWER LIMB VERTICAL SHEAR 2-LATERAL ROTATION ROTATIONAL INSTABILITY 3-PRINEAL ECHYMOSIS AND FLANK SCROTAL,LABIAL 4-RECTAL BLEEDING 5-VAGINAL BLEEDING URETHRAL BLEEDING -6

PHYSICAL EXAM 1-LATERAL COMPRETION (ILIAC WING) 2-ANTEROPOSTERIOR COMPRETION MAKE PAIN OR GROSS INSTABILITY 3-GAP OR PUBIS SYMPHYSIS SEPARATION 4-VAGINAL AND RECTAL EXAM HIGH POSISION PROSTAT=URETRA TEAR RECTAL EXAM IN CHILD ONLY WHEN HEMORAGE

5-NEROLOGIC EXAM SCIATIC NERVE AND LUMBOSACRAL BRANCHS IS NEAR Fx BULBOCAVVERNUS REFLEX MOTOR FUNCTION

IMAGING 1-STANDARD AP COLINEAR PUBIS SYMPHYSIS AND SACRAL SPINOUS PROCESS 1-DISPLASMENT OF SACRUM OR SI JOINT 2-L5 SPINOUS PROCESS FRACTURE 3-PUBIS SYMPHYSIS DIASTASIS OR RAMI Fx WITH DISPLACEd

PELVIC INLET PROJECTION 45 DEGREE CODAL 1-LATERAL ROTATION OF HEMIPELVIC 2-OPEN SI JOINT 3-IMPACT SACRAL ALA 4- AP DISPLACEMENT OF HEMIPELVIC

PELVIC OUTLET PROJECTION 45 DEGREE CEPHALAD 1- SACRUM 2-SI JOINT 3-VERTCAL DISPLACEMENT 4- UNSTABLE HEMIPELVIS

FLEXION EXTENTION DEFORMITY IS SEEN IN 3 XRAY BUT IS BETTER OUT LET VIEW( ROTATION POINT IS TYPICALY AT POSTERIOR RING)

CT SCAN 2-3 mm AXIAL SECTION IS GOOD FOR MAJORITY OF SIGNIFICANT INJURIES GOOD FOR THREE DIMENTIONAL RECONSTRACTIONS

CT IS INDICATED DOUBT ABOUT THE DIAGNOSIS IN PLAIN RADIOGHRAPH OPERATIVE INTERVENTION IS PLANNED

CT SCANNING CHANGED INJUREY CLASSIFICATION IN 15% MANAGEMENT IN 3% OF PATIENTS

CT AIDS DECISION FOR OPERATION AND CONSERVATIVE IMPROVE OPERATION APPROACH SELECTION

MANY TRAUMA CENTERS OPTAIN CT ROUTINLY FOR ABDOMEN AND PELVIC VISCERAL INJURY

MRI OFFERS SIMILAR BENEFITES OF CT,WITH THE ADVANTAGES OVER CT IN DELINEATING SOFT TISSUE INJURIES,ABSENCE OF IONIZING RADIATION,FRACTURES OF CARTILAGINOUS STRACTURES

RADIOISOTOPE BONE SCAN IS RARELY USEFUL FOR THE DIGNOSIS OF NONDISPLACED PELVIC FRACTURES AND IN THE IDENTIFICATION OF ACUTE INJURIES IN CHILDREN ADULTS WITH HEAD INJURIES OR MULTIPLE SYSTEM INJURIES

Unstable pelvic fractures cm pubis symphysis disruption 2-sacro spinous lig rapture 3-lateral sacral avulsion fx 4- ischial spine fx 5-sachral fx with gap(vertical Instability )

6-L5 TRANSVERS PROCESS FX (VERTICAL INSTABILITY ) 7-VERTICAL DISPLACEMENT OF HEMIPELVIS 1CM (VERTICAL) 8-STRES TESTING FOR INSTABILITY ONLY ONE TIME HEMODINAMIC INSTABILITY AND ZONE 2,3 SACRUM DUE TO NERVE INJURY

STABLE Fx 1- intact posterior ligament 2-impact fx of anterior sacrum In LC fractures) )