UNNECESSARY USE OF PELVIC X-RAY IN BLUNT TRAUMA

Pelvic radiography in blunt trauma patients is routinely used in most trauma centers, The purpose of this review was to evaluate the ability of physical examination alone to detect pelvic fractures. Among patie nts with blunt trauma admitted to the University Hospital del Valle in Call, Colombia, over a 3-month period, 608 adult patients, with hemod ynamic stability, without spinal involvement, and with a Glasgow Coma Scale score greater than 10 were evaluated. ALL patients had physical examination, pelvic x-ray and adequate follow-up. Fifty-nine (9.7%) pa tients had pelvic fractures, with 57 of these fractures detected by ph ysical findings. The remaining two patients had stable fractures that required no treatment, After careful analysis, we conclude that a nega tive physical examination following blunt trauma has a negative predic tive value of 99% probability in excluding pelvic fracture, provided t hat the patient is not a child, is not in coma, is hemodynamically sta ble without evidence of blood loss, and has no spinal cord injury. A s elective use of pelvic x-ray in patients with blunt trauma is a cost-e ffective policy.