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[External fixation for treatment of peripartum pubic symphysis separation : Clinical case and discussion]
M Müller1, F Greve2, M Zyskowski2
1Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland. michael.mueller@mri.tum.de.
Insights
Complete peripartum pubic symphysis separation is a rare birth complication. Surgical fixation with an external fixator yielded good results in a severe case.
Area of Science:
- Obstetrics and Gynecology
- Orthopedic Surgery
- Trauma Management
Background:
- Complete peripartum pubic symphysis separation is a rare, severe obstetric complication with an incidence of 0.03-3‰.
- Management varies from conservative (pelvic binder) for minor separations to surgical intervention for major dehiscence.
Observation:
- A 30-year-old woman experienced a complete pubic symphysis rupture during childbirth.
- Radiographic evaluation revealed a 39 mm dehiscence of the pubic symphysis.
Findings:
- The patient underwent surgical reduction and fixation using a supra-acetabular external fixator.
- The external fixator was maintained for 12 weeks.
Implications:
- This case highlights the successful surgical management of severe peripartum pubic symphysis separation.
- Supra-acetabular external fixation can be an effective treatment option for major pubic symphysis rupture, leading to good outcomes.
Abstract:
A complete peripartum pubic symphysis separation is a rare but severe complication of natural birth. Its incidence is estimated to be 0.03-3 ‰. Minor partial separations with a small width can be treated with a pelvic binder. Separations with major dehiscence should be treated by surgical reduction and fixation. This article presents the case of a 30-year-old woman who suffered a complete rupture of the pubic symphysis during the birth of her second child. Radiographic dehiscence was 39 mm. The operative treatment was carried out using a supra-acetabular external fixator for 12 weeks with a good result.
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