Obturator Artery Injury Resulting in Massive Hemorrhage From a Low-Energy Pubic Ramus Fracture

Pelvic ring fractures are common in the elderly population and are usually a result of low-energy trauma, such as falls from standing. In most cases, low-energy pelvic ring injuries can be treated with appropriate analgesia and early mobilization. Arterial injury resulting in hemodynamic instability from a low-energy pelvic ring injury is rare but, given the poor compliance of vessels in the elderly population, possible. These patients must be carefully monitored after the initial injury. The purpose of this report is to describe an elderly patient who sustained a superior pubic ramus fracture and arterial injury following a low-energy fall from standing that required angiographic intervention. Elderly patients who sustain low-energy or pelvic insufficiency fractures are unlike the younger population with high-energy pelvic fractures and hemodynamic collapse. Elderly patients can have a delayed presentation of arterial injury and require careful physical examination and close monitoring. Additionally, the authors provide a review of the literature for low-energy pelvic fractures. [Orthopedics. 2017; 40(3):e546-e548.].