title: Role of routine pelvic radiography in initial evaluation of stable, high-energy, blunt trauma patients.
abstract: BACKGROUND
  Pelvic fractures are among the most devastating traumatic injuries accompanied by high morbidity and mortality rate leading to catastrophic outcomes and haemodynamic consequences. Although Advanced Trauma Life Support (ATLS) recommends performing pelvic radiography in all major blunt trauma patients, several lines of evidence recommend that it can be limited to those blunt trauma patients who are haemodynamically unstable or have positive pelvic physical examination. Thus, we performed this study in order to evaluate the efficacy of routine pelvic radiography in haemodynamically stable, high-energy, blunt trauma patients.
  
  
  METHODS
  This was a prospective cross-sectional study including all the haemodynamically stable, high-energy, blunt trauma patients with negative pelvic physical examination referring to our trauma centre during a 5-month period (May-September 2010). Pelvic radiographies were performed and reviewed for abnormalities. In those who had negative pelvic physical examination and the radiography was not revealing enough, CT imaging was requested and reviewed.
  
  
  RESULTS
  During the study period, 1679 high-energy blunt trauma patients referred to our centre out of which 389 were haemodynamically stable and had negative pelvic physical examination. Pelvic radiography was found to be normal in all the patients except one (0.25%) who had pelvic fracture. Only three patients required CT imaging out of which two (0.5%) were found to be normal.
  
  
  CONCLUSIONS
  Pelvic radiography could be eliminated from the primary survey protocol of the patients with high-energy blunt trauma who are haemodynamically stable and have negative pelvic physical examination.
authors.affiliation: Trauma Research Center, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Paydar
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
authors.forename: Mehdi
authors.initials: M
authors.lastname: Foroughi
authors.forename: Ali
authors.initials: A
authors.lastname: Saberi
authors.forename: Maryam
authors.initials: M
authors.lastname: Dehghankhalili
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Abbasi
authors.forename: Babak
authors.initials: B
authors.lastname: Malekpoor
authors.forename: Ali Mohammad
authors.initials: AM
authors.lastname: Bananzadeh
authors.forename: Mohammad
authors.initials: M
authors.lastname: Vahid Hosseini
authors.forename: Shahram
authors.initials: S
authors.lastname: Bolandparvaz
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine; D005260:Female; D006439:Hemodynamics; D006620:Hip Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000000981:diagnostic imaging*