Pelvis/Hip Case 4 History/Physical Exam

Acetabular fracture (disruption of iliopectineal line)

Acetabular fractures are typically high-energy traumas, although elderly patients can sustain acetabular fractures from less severe mechanisms.

Physical exam should focus on identification of other major injuries. The soft tissue over the greater trochanter should be examined for damage because a closed degloving injury (Morel Lavallee lesion) is known to occur and is a surgical contraindication. The sciatic nerve is also at risk in these fractures and should be assessed. Urologic and rectal injuries are rare in isolated acetabular fractures, unlike other pelvic fractures from high energy trauma.