Presentation
MVA (unknown patient)
Patient Data
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.
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 hematoma 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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