ABSTRACT
Trauma to the pelvic ring is rare but potentially acutely life-threatening, as well as carrying the longer-term risk of significant morbidity and functional impairment. High-energy pelvic fractures are relatively rare in developed countries but are increasingly common in the developing countries. The right and left parts of the levator ani have a narrow gap that transmits the urethra, vagina, and anal canal. In men, the base of the bladder lies between the rectum and the pubic symphysis. The vagina sits between the urethra or bladder and the rectum. Features in the secondary survey that may highlight pelvic trauma include rectal bleeding and distal neurological deficit. Female patients with a vaginal tear or palpable fracture fragments adjacent to the urethra should also undergo urethrography. The association between residual displacement and outcome is difficult to quantify because more severe injury patterns are associated with higher rates of neurological, bladder, urethral and vascular injury.
