Open book pelvic injury - with follow-up

Case contributed by Leonardo Lustosa
Diagnosis certain


Motorcycle accident. Unstable pelvis on physical examination.

Patient Data

Age: 60 years
Gender: Male

The radiograph demonstrates an open book pelvic fracture, as shown by the marked pubic symphysis diastasis (53 mm).

Diastasis of the left sacroiliac joint.



Radiograph performed immediately post-op. The patient underwent open reduction and internal fixation with plating of the pubic symphysis and nailing of the left sacroiliac joint.

Case Discussion

Open book pelvic fractures are usually caused by high-energy trauma and are commonly associated with life-threatening vascular injuries.

The great degree of pubic symphysis diastasis may be distracting, but it remains important to review the whole pelvis, especially the sacroiliac joints, which are often injured as well.

In the present case, diastasis of the left sacroiliac joints was observed. This usually indicates that the sacroiliac ligaments are disrupted.

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