Haemodynamic Instability Secondary to Minimally Displaced Pubic Rami Fractures: A Report of Two Cases

Abstract

We report 2 patients with haemodynamic instability secondary to minimally displaced pubic rami fractures following a fall. Both complained of pain and swelling in the abdomen and groin, and had abdominal distension and bruising in the abdomen, groin, and perineum. All these may be early signs of severe vascular injury and should be treated promptly. Both patients were treated with embolisation of the injured vessels using emergency angiography.

Haemorrhage in fragility fractures of the pelvis

“…Of these 117 relevant papers, 8 met our inclusion/ exclusion criteria [5][6][7][8][9][10][11][12]. All papers were case reports.…”

“…All of these patients could be cardiopulmonarily stabilized by this procedure. Nevertheless, only three of these six patients survived [5,7,11]. One patient suffered brain death due to abdominal compartment syndrome [9], another died of respiratory and renal failure [10] and in one further therapy was aborted after subsequent deterioration [12].…”

“…They found that these fractures led to morbidity and mortality, but they did not describe bleeding complications. We identified eight case reports about patients with haemorrhage and/or haemodynamic instability as a complication of a low-velocity pelvic ring fracture [5][6][7][8][9][10][11][12]. In our review, an overview of the case reports is provided, risk factors identified and a recommendation for the treatment and clinical observation given.…”

Delayed Bleeding and Pelvic Haematoma after Low-Energy Osteoporotic Pubic Rami Fracture in a Warfarin Patient: An Unusual Cause of Abdominal Pain

“…Approximately 40% of the elderly with acute abdomen were misdiagnosed, and the overall mortality is approximately 10% [14]. Acute abdominal pain related to acute bleeding and pelvic haematoma after a low-energy pubic rami fracture has been rarely described [7, 15, 16]. Our patient was admitted to the hospital with abdominal pain associated with a delayed bleeding and pelvic haematoma 72 hours after trauma.…”

Orthopedic Implications of the Corona Mortis: A Case Report

“…Patients with pubic ramus fracture include young people sustaining high-energy trauma such as motor vehicle accident or falls from height and elderly people after minor falls (Henning et al; Theodorides et al; GarridoGomez et al; Palacio & Albareda). Early signs of vascular injury are clinical hypoperfusion, lower abdominal mass in the abdomen (Chiu et al, 2009;Theodorides et al).…”