Pelvis and sacroiliac claim
Pelvic fracture and sacroiliac injury after a motor accident
Pelvic claims may involve ring fracture, acetabular fracture, sacral fracture, sacroiliac disruption or a soft tissue SI sprain. These are not all assessed as lumbar spine injuries. Part 6 directs pelvic fractures to AMA4 section 3.4 and acetabular fractures to Table 64.
Motor accident mechanism
What can happen in a motor accident?
Rear-end crash
Seat-belt and dashboard loading can transmit force through the pelvis, hip and sacroiliac region.
Side-impact crash
Lateral intrusion can cause pelvic ring, acetabular or SI disruption.
Motorcycle fall
Landing on the hip or pelvis can cause sacral, acetabular or pelvic ring fracture.
Pedestrian impact
Direct bumper impact and ground contact can produce pelvic and lower-limb fractures or SI injury.
Injuries and diagnoses that may follow
- pelvic ring fracture
- acetabular fracture
- sacral fracture
- sacroiliac joint disruption or ligament injury
- associated urethral, nerve or lower-limb injury
Symptoms that should be recorded accurately
- groin, buttock, sacral or pelvic pain
- difficulty weight-bearing or walking
- pain with transfers, stairs or prolonged sitting
- leg-length, gait or hip symptoms
- neurological, urinary or sexual symptoms where associated structures are injured
Urgent medical signs
Suspected pelvic fracture after major trauma, inability to weight-bear, neurological change or bladder/urinary symptoms requires urgent medical assessment.
Clinical evidence
What medical findings matter?
The records should identify whether the injury is a fracture, SI disruption, ligament sprain, acetabular injury or referred lumbar pain. Pelvis and spine methods must not be mixed without justification.
| Record or test | What it can establish | What it cannot establish alone |
|---|---|---|
| Pelvic X-ray and CT | Defines ring, acetabular, sacral and SI fracture/disruption and displacement. | Imaging does not by itself describe long-term function or accident-related pre-existing issues. |
| Orthopaedic examination | Records weight-bearing, hip and SI findings, gait, leg length and neurological status. | Pain provocation alone does not establish rupture or a fixed WPI. |
| Operative report | Shows fixation, reduction, joint involvement and associated findings. | Surgery does not create an automatic impairment percentage. |
| Urology/neurology records | Address associated urethral, bladder, sexual or nerve injury. | Those impairments require their own objective evidence and body-system method. |
Part 5 classification
Is this likely to be threshold or non-threshold?
A verified pelvic, acetabular or sacral fracture is not a soft tissue injury and generally supports non-threshold classification. An SI sprain without verified rupture may be a threshold soft tissue injury. A partial or complete ligament rupture is excluded from the soft tissue definition, but it must be medically established.
Evidence that may support a threshold classification
- SI soft tissue sprain without verified rupture
- pelvic or buttock pain without structural injury
- referred lumbar symptoms
- imaging variation without accident-related diagnosis
Evidence that may support a non-threshold injury
- pelvic, acetabular or sacral fracture
- verified SI disruption or partial/complete ligament rupture
- associated nerve injury
- documented urinary tract or other organ injury
Part 6 permanent impairment
How is WPI assessed for this injury?
Pelvic fracture impairment is not assessed by spinal DRE unless there is a separate spinal injury. Clause 6.154 requires AMA4 section 3.4 (page 131); acetabular fractures use AMA4 Table 64 (pages 85-86). Clause 6.155 requires multiple pelvic fractures to be assessed separately and then combined.
- Identify each pelvic fracture and whether the acetabulum is involved.
- Assess multiple pelvic fractures separately before combining them.
- Assess a separate lumbar, neurological, urinary or lower-limb impairment under its own applicable method and combine only where permitted.
- Pain or SI tenderness alone does not create a table percentage; the structural and functional criteria must be satisfied.
What does not establish the result by itself?
- pelvic pain alone
- SI tenderness or a positive provocation test alone
- surgery alone
- mixing pelvic and lumbar DRE methods
- assuming every fracture has the same WPI
Accident-specific examples
Lateral crash causing acetabular fracture
Clause 6.154 directs the acetabular component to AMA4 Table 64 rather than a spinal DRE category.
Motorcycle fall with two pelvic fractures
Clause 6.155 requires each pelvic fracture to be assessed separately and then combined.
Rear-end crash with SI pain but no fracture or rupture
This may remain a threshold soft tissue injury. Pain provocation does not establish a non-threshold structural injury or WPI by itself.
Claim file preparation
Evidence checklist
Assessment source
Pelvic fracture and SI injury assessment source
Assessment source: Motor Accident Guidelines v10.1 clauses 6.154-6.155; AMA4 section 3.4 page 131; AMA4 Table 64 pages 85-86 for acetabular fractures; section 1.6 of the Motor Accident Injuries Act 2017 for threshold classification.
Threshold injury: Pelvic fracture is not a soft tissue injury. SI sprain may be threshold unless an excluded rupture, fracture, nerve injury or other structural injury is verified.
What the assessor checks
- pelvic section 3.4 method
- acetabular Table 64 method
- separate-and-combine rule for multiple fractures
- separate methods for associated injuries
What does not establish the result by itself
- pain or tenderness
- scan label without diagnosis and causation
- surgery
- lumbar DRE used for pelvis
Official sources
Related NSW CTP guides
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Frequently asked questions
- Is a pelvic fracture non-threshold?
- A verified accident-related bone fracture is not a soft tissue injury and generally supports a non-threshold classification.
- Is SI joint pain non-threshold?
- Not automatically. SI soft tissue sprain may be threshold unless fracture, verified rupture, nerve injury or another excluded injury is established.
- Is pelvic WPI assessed by DRE?
- No, not for the pelvic fracture itself. Clause 6.154 directs assessment to AMA4 section 3.4, with Table 64 for acetabular fractures.
- How are multiple pelvic fractures assessed?
- Clause 6.155 requires them to be assessed separately and then combined.
- Can urinary injury be included?
- Potentially, but it requires objective evidence and the applicable urinary/reproductive body-system method rather than being assumed from the pelvic fracture.