A middle-aged motorcyclist was brought to ED with a rare and potentially life-threatening fracture after an MVA left him with a pelvis split like an open book.

The 45-year-old had a history significant for low back pain and disc herniation, as well as a transforaminal lumbar interbody fusion of the L5 to S1 vertebrae five years earlier.

During examination, doctors noted bruising on the patient’s pubic area and severe pain in the anterior and posterior regions of the pelvis on manual compression, consistent with an unstable pelvis.

They therefore used circumferential sheeting to provide temporary pelvic ring stability. An AP pelvis X-ray revealed a wide gap in the pubic symphysis, measuring more than 5cm.