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.
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).
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.
2) revealed extensive pelvic fractures with displaced bilateral superior and inferior
pubic rami fractures and bilateral posterior ring crescent fractures.
The rectus abdominis was incised anteriorly longitudinally, the linea alba was split, and, though both heads of the rectus were elevated from the pubic symphysis, their attachments were maintained to the anterior aspects of the superior
pubic rami.
Lateral compression occurs due to a laterally applied force and may result in transverse or oblique fractures of the
pubic rami which may be either ipsilateral or contralateral to a posterior injury.
