Arterial injury following a low energy pubic rami fracture

Abstract

Patients with simple pubic rami fractures can be divided into two main groups: young people subject to high-energy trauma and elderly people who sustain osteoporotic fractures after minor falls. Cases associated with lifethreatening arterial injury mostly relate to the high-energy group. We report the case of a 70-year-old woman in whom a low-energy fall caused a stable pubic rami fracture injury associated with angiographyproven multiple hemorrhage from branches of both the internal and external iliac arteries which necessitated embolization of the bleeding vessels. As far as we are aware, angiography-proven bleeding from branches of the internal and external iliac arteries in a low-energy, stable pubic rami fracture has not been reported before. This case emphasizes the need for admission and careful hemodynamic monitoring in such cases.