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Massive haemorrhage after a low-energy pubic ramus fracture in a 71-year-old woman
  1. D J M Macdonald1,
  2. C J Tollan2,
  3. I Robertson3,
  4. B S Rana4
  1. 1Department of Orthopaedic Surgery, Western Infirmary, Glasgow, UK
  2. 2SHO II Plastic Surgery, Glasgow Royal Infirmary, Glasgow, UK
  3. 3Consultant Radiologist, The Department of Radiology, Gartnavel General Hospital, Glasgow, UK
  4. 4Department of Orthopaedic Surgery, Western Infirmary, Glasgow, UK
  1. Correspondence to:
 C J Tollan
 SHO II Plastic Surgery, Glasgow Royal Infirmary, Flat 3/1, 4 Dudley Drive, Glasgow G12 9SD, UK;cj_tollan{at}hotmail.com

Abstract

We describe a case of a patient receiving warfarin who presented with a superior pubic ramus fracture after a trivial fall at home. She developed a massive retroperitoneal haematoma as a result of vascular injury and subsequently died. This case emphasises the importance of admitting and observing patients with pubic rami fractures who are receiving antithrombotic treatment, and haemorrhage should be considered if they become haemodynamically compromised.

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