Irreducible Overlapping Pubic Symphysis Dislocation Managed with Distraction Osteotomy of the Contralateral Superior Pubic Ramus: A Rare Case Report.
| Autor: | Rajput R; Department of Orthopaedics, The Calcutta Medical Research Institute (CMRI), Kolkata, West Bengal, India., Pal KK; Department of Orthopaedics, The Calcutta Medical Research Institute (CMRI), Kolkata, West Bengal, India., Goel AK; Department of Orthopaedics, The Calcutta Medical Research Institute (CMRI), Kolkata, West Bengal, India., Mandal A; Department of Orthopaedics, The Calcutta Medical Research Institute (CMRI), Kolkata, West Bengal, India. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of orthopaedic case reports [J Orthop Case Rep] 2021 Jul; Vol. 11 (7), pp. 53-56. |
| DOI: | 10.13107/jocr.2021.v11.i07.2314 |
| Abstrakt: | Introduction: Overlapping pubic symphysis dislocation (OPSD) or a locked pubic symphysis is a compression of the pelvic ring with the intact pubis trapped into the contralateral obturator foramen. Reduction can be difficult and contralateral suprapubic osteotomy is a good way to address the irreducible OPSD. The technique has only been discussed thrice in the available literature. Case Report: We report the case of a 26-year-old man who had his right pubic ramus entrapped within the contralateral obturator foramen, having an overlap of >4 cm with associated ipsilateral sacroiliac joint (SI joint) disruption and urethral injury. When all the maneuvers of closed and instrumented open 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 and SI joint was stabilized with a 6.5mm percutaneous sacroiliac screw. The patient underwent delayed urethral repair at 10 weeks after the index surgery. At 3-year follow-up, the patient did not report any pubic discomfort, urinary and sexual problems. Conclusion: Locked OPSD is a rare injury and is frequently associated with sacroiliac and urethral injuries. Distraction osteotomy of the contralateral superior pubic ramus is a viable option for irreducible cases. Competing Interests: Conflict of Interest: Nil (Copyright: © Indian Orthopaedic Research Group.) |
| Databáze: | MEDLINE |
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