Date: Fri, 14 Mar 2003 14:27:43 +0100

Subject: Late ischial pain after pelvic fracture

From: Dr. Josep M. Muñoz Vives

50 yo male that suffered a RTA 14 years ago. He substained a femoral and pelvic fracture.

He works as a clerkman and complains of right isquiatic pain whenever he sits or walks for more than 1 hour.

Physical examination reveals no pelvic instability. Palpation of the isquion is painful. When he sits his pelvis tilts towards the left side.

MRI reveals no sign of bursitis.

How would you manage this patient.

Dr. Josep M. Muñoz Vives
Orthopedic Dept.
Hospital Universitari Dr. Josep Trueta.
Catalunya, Spain

Reply at: Orthopaedic Trauma Association forum

Date: Tue, 18 Mar 2003 19:26:42 -0500

From: Fred Barrick

He has a classic "weaver's bottom" problem from sitting on one ischium at all times. I am not sure that an MRI should be expected to show anything. I recommend a cushion that takes the weight off the right ishium and distributes to the left ishium and both thighs. I used a Roho quad cushion. in which one fourth can be deflated to distribute the weight to the other three sections.

Fred Barrick, MD
Director of Orthopaedic Trauma
Inova Fairfax Hospital
Falls Church, VA 22042