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Pubic and Ischial Ramus Fractures

Merck Manual of Geriatrics (3rd Edition), 2000

Fractures Topics:     | | | | | Pubic and Ischial Ramus Fractures | Pubic and Ischial Ramus Fractures Pubic ramus fractures are usually caused by a fall on level ground.
Normally, the pelvis bears weight mainly on the strong bony arches in the ilium, with the pubic and ischial rami acting as secondary tie arches.
However, because the rami are not needed for structural support for walking, weight bearing need not be restricted when the pain eases.
Localized tenderness in the groin and pain during leg movement suggest the diagnosis; x-rays confirm it.
In the presence of osteopenia, an undisplaced pubic ramus fracture may be difficult to diagnose; the fracture can become radiologically visible with callus formation.
Prognosis and Treatment Pubic ramus fractures typically heal without causing permanent functional disabilities.
Most patients feel considerable pain when standing or sitting and should be admitted to a hospital or skilled nursing care facility for monitoring of Hct and vital signs.
To avoid the complications associated with bed rest, patients should begin to walk, bearing weight fully, as soon as possible.
Most can walk short distances with a walker by 1 week and are moderately comfortable in 1 to 2 months.