Challenges in managing pubic ramus fractures Routine Computed Tomography for all pubic ramus fractures- Is there a role?

Abstract

Pelvic fractures are amongst the most common fragility fractures sustained by the elderly patient from falling from a standing height. There are significant complications arising from this type of fracture, ranging from the patient with haemodynamic compromise with an unstable pelvis to a patient with minimal displaced pelvic ring fracture without compromise. In this article, we aim to highlight those patients who may have had an innocuous injury but cannot mobilise despite analgesic optimization. There are currently two strategies undertaken with immediate CT imaging in all patients sustaining pelvic fractures at admission and delayed CT imaging for those patients who cannot mobilise. The main aim of imaging is to exclude the presence of a posterior pelvic ring injury and exclude any vascular injuries in the haemodynamically compromised patient.