Radha Sarkhell, Shenouda Michael, Hazlerigg Alexandra, Konan Sujith, Hulme Alison
Department of Trauma & Orthopaedics, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
Case Rep Orthop. 2013;2013:674732. doi: 10.1155/2013/674732. Epub 2013 Aug 12.
Pubic rami fractures are common. They are associated with significant morbidity and mortality. These fractures are usually classified as stable injuries and traditionally receive limited orthopaedic input. Management typically involves hospital admission and early input from physiotherapists and occupational therapists. Early mobilisation is advocated as a central part of managing these patients, with emphasis on secondary prevention. We report a case diagnosed as minimally displaced inferior pubic ramus fracture in a patient with an ipsilateral total hip replacement (THR). The patient was mobilised early and despite analgesia continued to complain of groin pain. Repeat radiographs showed a fracture of the acetabulum with displacement of the acetabular component of the hip replacement. We advocate early orthopaedic input for all pubic rami fractures, particularly in patients with hip arthroplasty, and thorough investigation including a CT scan of the pelvis to exclude acetabular extension prior to mobilisation.
耻骨支骨折很常见。它们与显著的发病率和死亡率相关。这些骨折通常被归类为稳定损伤，传统上骨科的介入有限。治疗通常包括住院以及物理治疗师和职业治疗师的早期介入。早期活动被提倡作为管理这些患者的核心部分，重点是二级预防。我们报告一例同侧全髋关节置换（THR）患者被诊断为耻骨下支轻微移位骨折的病例。患者早期进行了活动，尽管使用了镇痛措施，但仍持续抱怨腹股沟疼痛。复查X线片显示髋臼骨折伴髋关节置换髋臼部件移位。我们提倡对所有耻骨支骨折患者早期进行骨科介入，尤其是髋关节置换患者，并在活动前进行包括骨盆CT扫描在内的全面检查以排除髋臼延伸情况。
