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DO INNOCUOUS FRACTURES OF THE PELVIC RAMI REALLY EXIST?

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DO INNOCUOUS FRACTURES OF THE PELVIC RAMI REALLY EXIST?

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GuptaSK ; CoskerTDA ; and TaytonKJJ Royal Gwent Hospital, Newport, Gwent NP20 2UB A study of 50 consecutive osteoporotic pelvic rami fractures has been carried out to investigate the full extent of injury following low energy falls. 50 consecutive elderly patients with fresh fractures of the pelvis were each investigated with an MRI scan of the pelvis in order to assess the competency of the pelvic ring. The 50 patients consisted of 45 female and 5 males with a mean age of 77.7 years. 44 patients had unilateral pubic rami fractures. The mechanism of injury in all cases was a simple fall in the home environment. On admission 96% of the patients complained of sacral pain and were tender in the sacral or posterior pelvic region. On MRI, 90% of patients had a sacral fracture associated with the pubic rami fractures and in all but 4 of these the posterior pelvic pain was directly related to the sacral fracture site. At 6 month follow-up, 82% still complained of posterior pelvic tenderness.

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