<![CDATA[Background: The pelvic bone is a complex and vital structure that is susceptible to fractures, particularly in trauma cases such as traffic accidents. Pelvic examination for pubic ramus fractures at the Radiology Installation of Prof. Dr. R. Soeharso Orthopedic Hospital Surakarta differs from standard theory, particularly in the direction of the X-ray beam for the inlet–outlet projection and the use of an additional alar obturator projection. This study aimed to determine the pelvic examination technique and the use of examination projections for pubic ramus fractures at the hospital. Method: This study employed a qualitative method with a case study approach. The research was conducted at the Radiology Installation of Prof. Dr. R. Soeharso Orthopedic Hospital Surakarta from December 2025 to June 2026. The research subjects consisted of three radiographers and one radiologist. Data were collected through direct observation, in-depth interviews, and documentation, and were analyzed narratively through data reduction, theoretical comparison, and conclusion drawing. Results: The pelvic examination technique for pubic ramus fractures begins with a standard AP projection, followed by inlet projection (40° caudally) and outlet projection (40° cranially) to clearly demonstrate the pubic ramus, obturator foramen, and pubic symphysis. The alar obturator projection is additionally performed when fracture changes are identified in the acetabulum or iliac crest area. Conclusion: The additional alar obturator projection is an optional projection that is useful for demonstrating abnormalities in the acetabulum, ilium, and ischium. The combination of AP, inlet–outlet, and alar obturator projections provides more comprehensive radiographic visualization to support the diagnosis of pelvic fractures]]>
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