Unrestrained Passenger Injured in Car Accident

A 19-year-old man is transferred to your facility for injuries he sustained in a motor vehicle collision. He was an unrestrained passenger in a vehicle that went out of control and left the road. At the outside facility, he was found to have a chest injury and a pneumothorax, resulting in his transfer for tertiary level care. On arrival, he is complaining of some chest wall pain, but also states that his hips—especially the left one—are causing quite a bit of discomfort. His medical history is unremarkable except for sickle cell trait. Primary survey reveals stable vital signs and no obvious injury. On closer examination, with stress on his pelvis, he does complain of localized pain on the left side. Radiograph of the pelvis is obtained. What is your impression?