Total resection of the symphysis pubis in a patient with postpartum symphysitis: clinical case

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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.

作者简介

Yago Gudushauri

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: gogich71@mail.ru

MD, Dr. Sci. (Med.), Traumatologist-Orthopedist

俄罗斯联邦, Moscow

Malkhaz Kakabadze

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: malkhaz@mail.ru

MD, Cand., Sci. (Med.), Traumatologist-Orthopedist

俄罗斯联邦, Moscow

Anatoly Lazarev

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: lazarev.anatoly@gmail.com

MD, Dr. Sci. (Med.), Professor, Traumatologist-Orthopedist

俄罗斯联邦, Moscow

Vyacheslav Konovalov

Priorov National Medical Research Center for Traumatology and Orthopedics

编辑信件的主要联系方式.
Email: slava2801@yandex.ru
ORCID iD: 0000-0002-8954-9192
SPIN 代码: 9552-2408

Graduate Student, Traumatologist-Orthopedist

俄罗斯联邦, Moscow

Evgeny Kalinin

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: Kalinin_evgeny@mail.ru
ORCID iD: 0000-0003-2766-5670
SPIN 代码: 6659-2285

Graduate Student, Traumatologist-Orthopedist

俄罗斯联邦, Moscow

Ivan Marychev

Priorov National Medical Research Center for Traumatology and Orthopedics

Email: dr.ivan.marychev@mail.ru
ORCID iD: 0000-0002-5268-4972
SPIN 代码: 9151-7883

Graduate Student, Traumatologist-Orthopedist

俄罗斯联邦, Moscow

参考

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  3. 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
  4. 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
  5. 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).
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2. Fig. 1. Plain radiograph of the pelvic bones of patient S. Diastasis between the lumbar bones is more than 4 cm, there is a fuzziness of the articular surfaces of the pubic bones due to superficial bone erosion, a symmetrical spread of the process at different distances from the pubic symphysis.

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3. Fig. 2. Radiographs of patient S. after surgery: total resection of the pubic rami, replacement of the defect with plastic material Kollapan S, stabilization of the pelvic ring with an external fixation device of the MCC rod structure: a) straight line; b) caudal; and c) cranial projections.

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4. Fig. 3. Radiographs of patient S. 4 months after operation.

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5. Fig. 4. Appearance of patient S. after 4 months after operation.

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6. Fig. 5. Radiographs of the pelvis (cranial, straight and caudal) of patient S. 4 years after surgery.

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7. Fig. 6. Appearance of the patient S. 4 years after surgery.

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版权所有 © Gudushauri Y.G., Kakabadze M.G., Lazarev A.F., Konovalov V.V., Kalinin E.I., Marychev I.N., 2023

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