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The ‘nightstick’ ischial fracture: a unique oddity of the pelvic injury family
  1. Matthew John Gillespie1,
  2. Navnit S Makaram1,2,
  3. Tim O White1 and
  4. Samuel G Molyneux1
  1. 1Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2University of Edinburgh, Edinburgh, UK
  1. Correspondence to Navnit S Makaram; nmakaram{at}


We present an unusual ischial fracture unreported in the literature. We discuss the mechanism and describe the appropriate investigations and surgical management of this fracture. A 36-year-old man sustained a direct blow to his right buttock following a fall from a dirt bike. Examination revealed a firm haematoma, with severe pain on any stretch involving the posterior compartment of the thigh. Radiographs revealed a displaced fracture of the ischial body. CT confirmed integrity of the pelvic ring. The patient underwent open reduction and internal fixation with a partially threaded cannulated screw via a ‘modified longitudinal’ posterior approach to the ischium. The patient was managed partially weight-bearing for 6 weeks; 6-month follow-up confirmed satisfactory clinical and radiographic outcomes. Clinicians should be aware of this novel pelvic fracture and its unusual presentation, currently not included in any pelvic fracture classification system. We report a novel operative technique for appropriate surgical management of such injuries.

  • orthopaedic and trauma surgery
  • radiology
  • orthopaedics
  • trauma

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  • Contributors All authors were involved in the conception, data acquisition and manuscript preparation for this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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