Insufficiency fracture of the pubic rami

The patient was an 87-year-old woman referred to a physical therapist for right buttock and lateral calf pain of insidious onset that had been present for the past 3 weeks. She also complained of a 5-day history of right anterior hip/groin pain. Due to concern for a recent fracture of the right hip or pelvis, based on prior radiographs and the patient's medical history, radiographs were ordered that demonstrated new superior and inferior right pubic rami fractures. An orthopaedic surgeon was immediately consulted who diagnosed the patient with insufficiency fractures of the right pubic rami. The patient was instructed on toe touch weight bearing with a walker for the right lower extremity, and the orthopaedic surgeon recommended treatment by the physical therapist, as well as a reevaluation of the current management strategies for the patient's osteoporosis. J Orthop Sports Phys Ther 2010;40(10):666. doi:10.2519/jospt.2010.0416