Pubic rami 'ring' fractures

Case contributed by Dr Craig Hacking

Presentation

MVA (unknown patient hence 105 years old)

Patient Data

Age: 105
Gender: Female
X-ray

Pelvic binder noted. Medially displaced fracture of the right superior pubic ramus as it meets the anterior column of the right acetabulum. No corresponding inferior pubic ramus fracture. The hip joints are normally aligned. No sacroiliac joint widening.

CT

Subcutaneous fat stranding overlying the right sacroiliac joint posteriorly, consistent with a contusion.

Displaced fracture at the junction of the right superior pubic ramus and anterior column of the right acetabulum with a possible incomplete fracture of the right inferior pubic ramus.

No sacral fracture and the sacroiliac joint alignments are satisfactory. No large pelvic haematoma or midline shift of the pelvic structures.

Case Discussion

Good example of suspecting a second fracture in a ring structure.

When you see one fracture involving a ring structure, there is almost always a fracture, dislocation or ligamentous injury elsewhere in the ring.

Other bone rings include:

  • tibia and fibula
  • radius and ulna
  • orbit
  • neural arch
  • jaw
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Case information

rID: 36746
Case created: 9th May 2015
Last edited: 3rd Sep 2015
Inclusion in quiz mode: Included

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