Domínguez Carrillo, Luis Gerardo¹

Language: English/Spanish [Versión en español]
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Page: 157-158
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ABSTRACT

At the pelvic level, pubic rami fractures represent less than 0.3%. Due to their low incidence and non-specific symptoms, they can be confused with various muscle-tendon disorders. The treatment of pelvic ring fractures requires detailed knowledge of the anatomy of the pelvis and the mechanism of injury, as well as a precise clinical and radiological evaluation. Decision-making depends on the analysis of pelvic stability and deformation. Given the diversity of pelvic injuries and the presence of associated injuries or other variables, the risk of injury is high.

A 53-year-old male suffered a fall from a height of three meters, impacting a dirt floor directly on his left greater trochanter. He presented with severe pain in the left greater trochanteric region and bilateral inguinal pain. He went to the emergency department, where radiographic studies were performed; however, bilateral iliopubic rami fractures went unnoticed.

He attended the rehabilitation service one month later. On physical examination, ecchymosis was observed in the greater trochanteric region, along with tenderness to digital pressure on the pubis and the iliopubic rami bilaterally, as well as pain-induced limitation in internal rotation of both coxofemoral joints. A review of the initial pelvis radiograph showed non-displaced fractures of both iliopubic rami, corresponding to a stable type A injury (Figure 1).

At the pelvic level, pubic rami fractures account for less than 0.3%. Due to their low incidence and nonspecific symptomatology, they can be confused with various muscle-tendon alterations. The treatment of pelvic ring fractures requires detailed knowledge of pelvic anatomy and the injury mechanism, as well as an accurate clinical and radiological evaluation. Decision-making depends on the analysis of pelvic stability, given the diversity of pelvic injuries and the presence of associated lesions or other variables.

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AFFILIATIONS

¹ Especialista en Medicina de Rehabilitación. División de Medicina del Hospital Angeles León. León, Guanajuato. México. ORCID: 0000-0002-1985-4837

CORRESPONDENCE

Dr. Luis Gerardo Domínguez Carrillo. Correo electrónico: lgdominguez@hotmail.com

Received: 2024-09-02. Accepted: 2024-09-19.