Sacral ala and bilateral pubic rami fractures

Case contributed by Dr Craig Hacking

Presentation

MVA. Tubed at the scene.

Patient Data

Age: 30
Gender: Female

Pelvic binder noted. Comminuted displaced fractures of the bilateral superior and inferior pubic rami, more displaced on the left. The pubic symphysis however maintains normal width.

No widening of the sacroiliac joints. Loss of the normal right sacral anterior foraminal lines suggests a right sacral fracture. Hip joints are normally located. CT advised.

Obliquely orientated comminuted fracture of the right sacral ala with involvement of the sacroiliac joint anteriorly without significant diastasis. The fracture extends distally and involves the right S1-S3 neural foramina. Surrounding haematoma noted. Also swollen right piriformis muscle indicating intramuscular haematoma. No focal contrast blush.

There also comminuted and displaced fractures of bilateral inferior and superior pubic rami. Minor right pelvic side wall haematoma from the pubic fractures.

Case Discussion

Loss of the 'seagull' curvilinear lines on the anterior aspect of the sacral is a sign of sacral fracture.

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Case information

rID: 39601
Case created: 11th Sep 2015
Last edited: 23rd Apr 2017
Inclusion in quiz mode: Included

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