A locked pubic ramus body is an unusual variant of lateral compression injury. Till date, there have been only 25 cases reported in the published literature. We herein described a case where the right pubic ramus was entrapped within the opposite obturator foramen with an overlap of greater than 4 cm, with associated urethral injury. When all maneuvers of closed and instrumented reduction failed, we performed a superior pubic ramus osteotomy on the left side and unlocked the incarcerated right pubic ramus. The osteotomy site was stabilized with a 6-hole recon plate. The patient underwent delayed urethral repair 10 weeks after the index surgery. At 3-year follow-up, the patient has sexual dysfunction especially difficulty in maintaining erection, secondary urethral stricture, heterotopic ossification, and breakage of implants.
Humans ; Pubic Bone/injuries* ; Follow-Up Studies ; Osteotomy, Sagittal Split Ramus ; Pelvis ; Urethra/surgery* ; Pubic Symphysis/injuries*

OBJECTIVE: To review the research progress of pubic symphysis diastasis and provide effective reference for orthopedic surgeons in the diagnosis and treatment of pubic symphysis diastasis. METHODS: The anatomy, injury mechanism, treatment, and other aspects of pubic symphysis diastasis were summarized and analyzed by reviewing the relevant research literature at domestically and internationally in recent years. RESULTS: The incidence of pubic symphysis diastasis is high in pelvic fractures, which is caused by the injury of the ligaments and fibrocartilage disc around the pubic symphysis by external force. The treatment plan should be individualized according to the pelvic stability and the needs of patients, aiming to restore the stability and integrity of the pelvis and improve the quality of life of patients after surgery. CONCLUSION At present, the research on pubic symphysis diastasis still needs to be improved. In the future, high-quality, multi-center, and large-sample studies are of great significance for the selection of treatment methods and the evaluation of effectiveness for patients with pubic symphysis diastasis.
Female ; Humans ; Pubic Symphysis Diastasis/etiology* ; Quality of Life ; Pubic Symphysis/injuries* ; Pelvis/surgery* ; Fractures, Bone/surgery*

OBJECTIVE: To explore application value of ultrasound in treating postpartum pubis symphysis diastasis by bone setting manipulation. METHODS: Retrospective analysis was performed on 30 patients (case group) with postpartum pubis symphysis diastasis diagnosed in Wangjing Hospital, China Academy of Chinese Medical Sciences from June 2017 to January 2021, aged from 21 to 43 years old, with an average of (33.0±3.5) years old. The main clinical manifestations were mobility disorders such as turning over and walking, and all patients were treated by bone setting manipulation. Before and after treatment, pain and degree of pubic symphysis separation were evaluated by visual analogue scale(VAS) and ultrasonography. In normal group, 30 menopausal women aged from 49 to 59 years old with an average of(54.0±2.9) years old who wanted to remove intra uterine device(IUD) and were underwent conventional pelvic plain radiographswere selected, and the width of pubic symphysis space was measured by ultrasound and plain radiographs. RESULTS: In normal group, the width of pubic symphysis was about (5.2±1.7) mm by ultrasonography, X-ray measurement was (5.0±2.1) mm, and showed no difference(P>0.05).In case group, the width of pubic symphysis measured by ultrasound before manipulation was about (9.5±1.8) mm, VAS was 6.05(5.27, 6.80) scores;while the width of pubic symphysis measured by ultrasound before manipulation was about (5.8±1.3) mm, VAS was 0(0, 0) scores, and there were statistical difference before and after manipulation (P<0.05). CONCLUSION Ultrasound is examation method with safe, non radioactive, easy to repeat for many times, could clearly show cartilage, ligament and bone structure around pubic symphysis, and is more suitable for the imaging diagnosis of postpartum pubis symphysis diastasis, which provide quantitative imaging basis for clinical evaluation of the curative effect of bone setting manipulation in treating postpartum pubis symphysis diastasis.
Adult ; Female ; Humans ; Middle Aged ; Postpartum Period ; Pubic Bone ; Pubic Symphysis Diastasis/therapy* ; Retrospective Studies ; Ultrasonography ; Young Adult

Arteries ; Fractures, Bone ; Humans ; Pubic Bone ; Vascular System Injuries

PURPOSE: Corona mortis is an abnormal arterial or venous anastomosis between the external iliac and the obturator system of vessels and may cause significant hemorrhage during pelvi-acetabular fracture surgeries, hernia repair and laparoscopic gynecological procedures. Previous studies have estimated a prevalence of corona mortis between 34% and 70%. This cadaveric study was conducted to estimate the prevalence of corona mortis in the North Indian population. MATERIALS AND METHODS: Twelve cadavers (24 hemipelvises; 11 males and 1 female) with a mean age of 68 (range, 54–82) years were included in this study. RESULTS: Corona mortis was observed in 14 hemipelvises (58.3%). A total of 19 (79.2%) vascular anastomoses of diameter greater than 1 mm were observed; 5 hemipelvises (20.8%) had corona mortis on the right side, 9 hemipelvises (37.5%) on the left side and bilateral in 5 (41.7%) cases. Two hemipelvises (8.3%) had an arterial connection. An aberrant obturator artery was observed in 1 (4.2%) hemipelvis. A venous connection was found in 14 specimens (58.3% of hemipelvises). The average distance of the connecting vein from the symphysis pubis was 41 (35–70) mm. A vessel diameter of greater than 4 mm was observed in 4/24 (16.7%) of hemipelvises. CONCLUSION: The frequency of venous corona mortis was higher than arterial corona mortis and the majority (83.3%) were small calibre ( < 4 mm). The presentation pattern and the number of arterial or venous anastomoses were different in the majority of hemipelvises and dissimilar in both hemipelvises of the same cadaver in the majority of cases.
Acetabulum ; Arteries ; Blood Vessels ; Cadaver ; Hemorrhage ; Herniorrhaphy ; Humans ; Male ; Prevalence ; Pubic Bone ; Veins

Phthirus pubis usually infests the pubis, groin, buttocks and perianal region. It can sometimes infest the thighs, abdomen, chest, axillae and beard. Eyelashes and eyebrows may be involved in children. The involvement of the scalp is very rare. We describe a case of P. pubis infestation located exclusively on the scalp in an adult woman. Neither lice/nits nor skin lesions were observed elsewhere, including eyebrows, eyelashes, axillae, pubis, buttocks and perianal region (the patient was hairless in the axillae and pubis). A review of the literature is enclosed.
Abdomen ; Adult ; Axilla ; Buttocks ; Child ; Eyebrows ; Eyelashes ; Female ; Groin ; Humans ; Phthirus ; Pubic Bone ; Scalp ; Skin ; Thigh ; Thorax

OBJECTIVE: For patients who had hemipelvectomies involving the resection of a portion or the whole of the pubis, bony reconstruction was not recommended commonly. However, the soft tissue reconstruction of the lower abdominal wall may benefit these patients. The object of the study was to determine the clinical effect of lower abdominal wall reconstruction with LARS ligament after pubic tumor resection interms of patient-reported and objective outcome. METHODS: In this series, we reviewed twenty-five patients who underwent pubic tumor resection followed by reconstruction with LARS ligament between February 2012 and February 2018 retrospectively. We evaluated the clinical outcome and complication of this surgical treatment. The function outcome was evaluated according the musculoskeletal tumor society scores (MSTS) for all the patients at the end of the last follow-up. RESULTS: All the patients were stable during the surgery. There were eight patients who underwent resection of superior ramus of pubis, five patients who had resection of inferior ramus of pubis, and twelve patients who received both superior and inferior ramus of pubis. For all the patients, the mean blood loss was (774±580) mL. The mean operation time was (138±25) min. The mean hospital stay was (19±6) d. For the patients who had resection of superior ramus, inferior ramus, as well as both superior and inferior ramus, the mean blood loss were (763±802) mL, (730±315) mL and (808±485) mL, respectively. The mean operation time were (133±27) min, (135±35) min and (143±20) min, respectively. The mean hospital stay were (18±5) d, (22±9) d and (19±6) d, respectively. The mean follow-up time was (37±21) months. Local recurrence was observed in one patient with chondrosarcoma. One patient with renal cancer metastasis died of the disease. No ligament infection, ligament related complication and incisional hernias were observed. Twenty-three patients could ambulate without assistive devices, and the remaining two could walk by crutches. Postoperative pain was reported as none in nineteen patients, mild in three, and moderate in three. From a functional point, the mean MSTS score was 87±4. CONCLUSION Lower abdominal wall reconstruction with LARS ligament after pubic tumor resection could have satisfactory clinical outcome. It could prevent the occurrence of herniation, decrease the infection rate by minishing the dead space, and achieve good patient-reported outcome.
Abdominal Wall ; Humans ; Ligaments ; Neoplasm Recurrence, Local ; Prostheses and Implants ; Pubic Bone/surgery* ; Reconstructive Surgical Procedures ; Retrospective Studies ; Treatment Outcome

Osteochondromas develop as cartilaginous nodules in the periosteum of bones. They are the commonest benign tumors of the skeleton, generally observed in the long bones. Rarely, they are also found in the axial skeleton, flat bones of skull and facial bones. During a regular dissection, we came across a solitary osteochondroma in posterior surface of the body of the right pubic bone. Histopathology of the bony projection confirmed the typical features of the osteochondroma. The symptomatic osteochondromas are usually evaluated during radiographic examination. Though, the observed osteochondroma is relatively smaller its unusual location is remarkable and knowledge of occurrence of such nodules is clinically important during the diagnosis and planning of treatment.
Cadaver* ; Diagnosis ; Facial Bones ; Osteochondroma* ; Periosteum ; Pubic Bone* ; Skeleton ; Skull

BACKGROUND: The umbilicus makes an important contribution to the natural appearance of the abdomen. To date, studies on its position in Korean women are lacking, and no standards have been established. The purpose of this study was to investigate the position of umbilicus in Korean women and to review changes in its position after ipsilateral pedicled rectus abdominis musculocutaneous (IP-RAM) flap. METHODS: This research consisted of two studies. In first study, 100 females who visited the emergency department with gastroenteritis between 2007 and 2011 were included. In second study, 40 women who underwent IP-RAM flap in the same period were included. Using abdominal computed tomography, we measured the distance between xiphoid process and umbilicus, represented by value a, and the distance between umbilicus and symphysis pubis, represented by value b. Thus, the location of the umbilicus was represented by the ratio a/b. The data were analyzed using Pearson correlation test and paired t-test. RESULTS: In study 1, the mean value of a/b was 1.07. Pearson correlation test revealed a significant correlation between age and a/b. In study 2, the mean value of a/b was 1.16 in preoperative measurements and 1.01 in postoperative measurements. The paired t-test showed a significant difference between preoperative and postoperative measurements, indicating cephalic migration of the umbilicus after surgery. CONCLUSIONS: The natural position of the umbilicus showed caudal migration with aging. Additionally, in a comparison of preoperative and postoperative measurements in patients who underwent IP-RAM flap, cephalic migration of the umbilicus was observed after surgery.
Abdomen ; Aging ; Breast* ; Emergency Service, Hospital ; Female ; Gastroenteritis ; Humans ; Mammaplasty* ; Myocutaneous Flap* ; Pubic Bone ; Pubic Symphysis ; Rectus Abdominis* ; Umbilicus* ; Xiphoid Bone

We report a patient who experienced no function problems during the 5-year follow-up after a conservative treatment for minimally displaced acetabular fracture that developed as a result of the formation of physeal bar. According to the computed tomography, triradiate cartilage was fractured and minimally displaced, which was identified as a Salter Harris type II physeal injury. A fracture of the anterior wall of the acetabulum was also observed. It was judged as a stable fracture, and conservative treatment was performed. On the follow-up x-ray, the physeal bar was formed in the damaged triradiate cartilage. At 5-year follow-up, physeal injury of the triradiate cartilage has influenced the acetabular growth, resulting in acetabular dysplasia, pelvic asymmetry, hypoplasia of pubis, and widening of the tear drop. However, anteversion and inclination of the injured acetabulum were similar with those of the contralateral side. Our patient also did not complain of any hip discomfort.
Acetabulum ; Cartilage ; Follow-Up Studies ; Hip ; Humans ; Pubic Bone ; Tears