Which of the following is an indication of a pelvic fracture?

• A. Unconsciousness or shock
• B. Any major lower limb amputation or near amputation
• C. Pelvic pain
• D. Pelvic instability, crepitus or unequal leg lengths

Answer: (D)

In pelvic trauma, the most reliable signs come from disruption of the pelvic ring. Pelvic instability means the pelvis moves abnormally when palpated or moved, crepitus is a grinding or crackling sensation from fractured pelvic bones, and unequal leg lengths occur when the pelvic ring is disrupted, tilting or shortening one side. These findings specifically point to a pelvic fracture. Unconsciousness or shock is a general sign of severe injury, not specific to the pelvis; a major lower limb amputation isn’t related to a pelvic fracture; pelvic pain alone is nonspecific and can occur with many injuries. So the combination of instability, crepitus, or leg-length discrepancy best indicates a pelvic fracture.