RT Book, Section A1 Barlotta, Kevin S. A1 Stack, Lawrence B. A1 Knoop, Kevin J. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181040948 T1 Pelvic Fracture T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181040948 RD 2024/10/03 AB Pelvic fractures are most often the result of motor vehicle crashes or falls and are fraught with complications. The pelvis should be regarded as a ring; identification of one fracture or dislocation should prompt surveillance for another. Trauma to the genitourinary (GU) tract is suggested by blood at the urethral meatus, a high-riding prostate, gross hematuria, or scrotal hematoma. Spinal nerves, the lumbosacral plexus, the sacral plexus, and the major lower extremity peripheral nerves, such as the sciatic, femoral, obturator, and pudendal nerves, are found in close proximity to the pelvis. A neurologic examination of the lower extremities should include a rectal examination to assess tone. The iliac arteries, veins, and their branches are also enveloped by the bony architecture of the pelvis, and severe hemorrhage is a common complication. While ecchymosis of the anterior abdominal wall, flank, sacral, or gluteal region suggests hemorrhage, there may be no outward signs of a severe hemorrhage. Blood found during rectal or vaginal examination may indicate a puncture wound from the fracture.