A clinical and experimental investigation of occult injuries of the pelvic ring.
Apparently isolated fractures of the pubic rami must be associated with damage elsewhere in the pelvic ring. In a clinical review of 20 patients it was demonstrated that radiographic evidence of isolated fractures of the pubic rami was associated with the increased uptake of technetium polyphosphate on bone scans in either the sacroiliac joints or the acetabulum. The nature of the injury causing increased uptake was evaluated by means of an experimental study creating pelvic injuries in rabbits. Radiographs, bone scans, autoradiographs and histological sections of the pelves of these animals all showed evidence of microavulsion fractures of the subchondral bone mediated through the sacroiliac ligaments and Sharpey's fibres. The associated injuries account for the clinical picture in patients who complain of pain in the hip and sacroiliac region following fractures of the pubic rami. The clinical and radiographic evidence presented clearly demonstrates that an injury at one site in the pelvic ring must be associated with another on the other side of the ring. Furthermore, the technique developed for autoradiography of the animal pelves provides a new and useful tool for further study of injury to bones and ligaments.
D000818:Animals; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D011817:Rabbits; D011859:Radiography