Bilateral superior and inferior rami fractures are known as a straddle injury. This was originally described in horseback riders and is the result of direct trauma. Urethral injury is a known complication.

A	AP radiograph of the pelvis. This shows bilateral inferior and superior pubic rami fractures

Links to online textbooks:

• Wheeless' Orthopedics: discussion of complications from pelvic fractures

References:

• Greaney H, Ryan J: Straddle injuries--is current practice safe? Eur J Emerg Med. 1998 Dec;5(4):421-4.           [See related articles]
• Dowd MD, Fitzmaurice L, Knapp JF, Mooney D: The interpretation of urogenital findings in children with straddle injuries J Pediatr Surg. 1994 Jan;29(1):7-10.           [See related articles]