Pubic ramus fractures

Rami fractures can be: 

• Unilateral in combination with another pelvic injury 
• Bilateral in combination with another pelvic ring injury or isolated

Isolated ramus fractures do not occur.

Associated urogenital injury is common for dislocated rami fractures.

Fractures with minimal or no displacement are intrinsically stable due to specific ligament support (ilioinguinal and pectineal ligaments as well as the obturator membrane).

All of these injuries should be addressed together with any other injury to the pelvic ring.

Unilateral fractures are mostly caused by compressive forces.

Bilateral fractures are mostly caused by direct blow to the anterior pelvis.