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Physical Exam

  • Presence of Shock
  • Inspection
  • Palplation:
    • symphysis, pubic rami, iliac crests, sacroiliac;
    • bimanual compression & distraction of the iliac wings, & abduction & adduction of the hip should be done to detect instability;
    • manual traction can aid in the determination of vertical instability
      • grasp both legs and pull one caudad while pushing the other cephalad
    • Neurologic Injury
  • Associated Fractures:
  • Gyn, Urinary & Rectal Injuries:
    • RUG vs. Suprapubic catheter;
    • Rectal and Vaginal exams should be performed in order to determine whether the pelvic injury communicates w/ these structures.
      • lacerations indicate an open fracture (need for colostomy)
      • during the rectal examination, the examiner can gently palpate the sacrum for tenderness or asymmetry.