Total resection of the symphysis pubis in a patient with postpartum symphysitis: clinical case
- Authors: Gudushauri Y.G.1, Kakabadze M.G.1, Lazarev A.F.1, Konovalov V.V.1, Kalinin E.I.1, Marychev I.N.1
-
Affiliations:
- Priorov National Medical Research Center for Traumatology and Orthopedics
- Issue: Vol 29, No 3 (2022)
- Pages: 289-296
- Section: Clinical case
- URL: https://journals.rcsi.science/0869-8678/article/view/140771
- DOI: https://doi.org/10.17816/vto108842
- ID: 140771
Cite item
Full Text
Abstract
BACKGROUND: Complete rupture of the symphysis during childbirth is a rare but serious complication, with a frequency of 0.03%–3%. Small partial tears with minor discrepancies are an indication of conservative therapy, which only requires the use of a pelvic brace. Larger symphyseal tears should be treated with surgery and fixation.
CLINICAL CASE DESCRIPTION: This report presents a clinical case of successful orthopedic correction of symphysitis after delivery by cesarean section. A 25-year-old patient underwent total resection of the symphysis pubis with supra-acetabular fixation and external fixation device of a rod arrangement for 12 weeks.
CONCLUSION: Several surgical techniques in combination with defect plasty with biocomposite material KollapAn-С made it possible to achieve a long-term positive result.
Full Text
##article.viewOnOriginalSite##About the authors
Yago G. Gudushauri
Priorov National Medical Research Center for Traumatology and Orthopedics
Email: gogich71@mail.ru
MD, Dr. Sci. (Med.), Traumatologist-Orthopedist
Russian Federation, MoscowMalkhaz G. Kakabadze
Priorov National Medical Research Center for Traumatology and Orthopedics
Email: malkhaz@mail.ru
MD, Cand., Sci. (Med.), Traumatologist-Orthopedist
Russian Federation, MoscowAnatoly F. Lazarev
Priorov National Medical Research Center for Traumatology and Orthopedics
Email: lazarev.anatoly@gmail.com
MD, Dr. Sci. (Med.), Professor, Traumatologist-Orthopedist
Russian Federation, MoscowVyacheslav V. Konovalov
Priorov National Medical Research Center for Traumatology and Orthopedics
Author for correspondence.
Email: slava2801@yandex.ru
ORCID iD: 0000-0002-8954-9192
SPIN-code: 9552-2408
Graduate Student, Traumatologist-Orthopedist
Russian Federation, MoscowEvgeny I. Kalinin
Priorov National Medical Research Center for Traumatology and Orthopedics
Email: Kalinin_evgeny@mail.ru
ORCID iD: 0000-0003-2766-5670
SPIN-code: 6659-2285
Graduate Student, Traumatologist-Orthopedist
Russian Federation, MoscowIvan N. Marychev
Priorov National Medical Research Center for Traumatology and Orthopedics
Email: dr.ivan.marychev@mail.ru
ORCID iD: 0000-0002-5268-4972
SPIN-code: 9151-7883
Graduate Student, Traumatologist-Orthopedist
Russian Federation, MoscowReferences
- Dyatlov MM. Slozhnye povrezhdeniya taza. Chto delat’? Rukovodstvo dlya vrachei i studentov. Gomel’: GomGMU; 2006. (In Russ).
- Lazarev AF, Gudushauri YG, Kostiv EP, et al. Challenging issues of the doctrine of the pelvis polytrauma. Pacific Medical Journal. 2017;1:17–23. (In Russ). doi: 10.17238/PmJ1609-1175.2017.1.17-233
- Gudushayri YG, Lazarev AF, Verzin AV. Surgical Correction of the Sequelae of Obstetric Pubic Symphysis Ruptures. N.N. Priorov Journal of Traumatology and Orthopedics. 2014;21(4):15–21. (In Russ). doi: 10.17816/vto20140415-21
- Lazarev AF, Solod EI, Gudushauri YG, et al. Problems with fixing chronic injuries of the anterior pelvic ring. N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(3):5–12. (In Russ). doi: 10.17816/vto89514
- Lazarev AF, Verzin AV, Solod EI, et al. Urologicheskie problemy posledstvii povrezhdeniya perednego polukol’tsa taza. Proceedings of the III International Pirogov Student Scientific Medical Conference «Osteosintez i endoprotezirovanie»; 2008 March 20; Moscow. Available from: https://pirogovka.rsmu.ru/fileadmin/templates/DOC/Conferences/Pirogovka/Sbornik_tezisov_2008.pdf. Accessed: 20.12.2022. (In Russ).
- Stel’makh KK. Lechenie nestabil’nykh povrezhdenii taza. Traumatology and Orthopedics of Russia. 2005;38(4):31–38. (In Russ).
- Seth S, Das B, Salhan S. A severe case of pubic symphysis diastasis in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2003;106(2):230–232. doi: 10.1016/s0301-2115(02)00221-x
- Gudushauri YaG. Operativnoe lechenie oslozhnennykh perelomov kostei taza [dissertation]. Moscow; 2016. Available from: https://www.cito-priorov.ru/cito/dissovet/36/%D0%B4%D0%B8%D1%81%D1%81%D0%B5%D1%80%20%D0%93%D1%83%D0%B4%D1%83%D1%88%D0%B0%D1%83%D1%80%D0%B8-1.pdf. Accessed: 20.12.2022. (In Russ).
- Mikhel’son AF, Topolyan HA, Volkov AE. Printsipy vedeniya bol’nykh s poslerodovymi simfizitami. Collection of Scientific Works «Aktual’nye voprosy akusherstva i ginekologii»; 2001–2002; Moscow. Vol. 1, N 1. P. 55–56. (In Russ).
- Kozlov LA, Klyucharov IV. Changes of the pubic joint in obstetric practice: terminology, classification, diagnosis, and medical tactics. Kazan medical journal. 1997;78(3):218–220. (In Russ). doi: 10.17816/kazmj81508
- Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg. 1989;71(2):304–306. doi: 10.1302/0301-620X.71B2.2925751
- Norvilaite K, Kezeviciute M, Ramasauskaitė D, et al. Postpartum pubic symphysis diastasis-conservative and surgical treatment methods, incidence of complications: Two case reports and a review of the literature. World J Clin Cases. 2020;8(1):110–119. doi: 10.12998/wjcc.v8.i1.110
- Waikakul S, Soparat K, Harnroongroj T. Anterior stabilization in the pubic symphysis separation: a mechanical testing. J Med Assoc Thai. 1999;82(1):72–79.