Citation

Gillespie MJ, Makaram NS, White TO, Molyneux SG. BMJ Case Rep. 2021; 14(2): e240874.

Copyright

(Copyright © 2021, BMJ Publishing Group)

DOI

10.1136/bcr-2020-240874

PMID

unavailable

Abstract

We present an unusual ischial fracture unreported in the literature. We discuss the mechanism and describe the appropriate investigations and surgical management of this fracture. A 36-year-old man sustained a direct blow to his right buttock following a fall from a dirt bike. Examination revealed a firm haematoma, with severe pain on any stretch involving the posterior compartment of the thigh. Radiographs revealed a displaced fracture of the ischial body. CT confirmed integrity of the pelvic ring. The patient underwent open reduction and internal fixation with a partially threaded cannulated screw via a 'modified longitudinal' posterior approach to the ischium. The patient was managed partially weight-bearing for 6 weeks; 6-month follow-up confirmed satisfactory clinical and radiographic outcomes. Clinicians should be aware of this novel pelvic fracture and its unusual presentation, currently not included in any pelvic fracture classification system. We report a novel operative technique for appropriate surgical management of such injuries.

Language: en

Keywords

trauma; orthopaedic and trauma surgery; orthopaedics; radiology