Haemodynamic instability secondary to minimally displaced pubic rami
fractures: a report of two cases.
Since the Cooper ligament was destroyed, it was dissected to allow direct visualization of the pubic rami
. The abdominal wall defect was measured to be 10 x 12 cm.
On further investigation, magnetic resonance imaging (MRI) of the pelvis revealed an increased distance between the pubic rami
measuring 16 mm in the midline with disruption of associated ligaments.
After delivery, plain radiograph showed erosions all through both pubic rami
, which were more prominent at the inferior part.
Incomplete fusion of the ischiopubic rami or absent superior and inferior pubic rami
were also found.
Caption: Figure 3: Arms of the mesh sling dissected away from the abdominal wall near the pubic rami
prior to vaginal removal.
An initial radiograph preformed in the emergency department revealed a left pubic rami
fracture (Figure 1).
Fractures detected included superior and inferior pubic rami
fracture, fracture of superior pubic ramus, fracture of ischial spine and acetabular fracture.
(37) With weightbearing, the superior pubic rami
and the pubic symphysis act as a compression strut, linking the femur to the posterior pelvic structures and spine, with the centers of rotation being near the pubic symphysis.
He struck a tree while driving home from work and sustained multiple injuries including traumatic ventral hernia, traumatic left testicular hematoma, open bilateral superior and inferior pubic rami
fractures, scalp laceration, nasal bone fractures, and bilateral occipital condyle fractures.
Plain radiographs revealed symmetric fracture zones in both of her superior pubic rami
and inner margins of the femoral neck (Figure 1).
Physical examination revealed chronic illness with localised pain to the left pubic rami
. Special investigations included normal blood work and a normal CXR; a whole-body bone scintigraphy study demonstrated multiple osteoblastic metastases in the skull, ribs, both scapulae, the superior and inferior pubic rami
on the left, both femurs and the proximal two-thirds of the right humerus (Fig.