Surgical Treatment of Peripartum Pelvic Ring Injury: Case Report

During the gestational period, the pubic symphysis dilates for vaginal delivery. However, exacerbated widening may indicate ligament injury and pelvic instability, resulting in significant pain complaints. This uncommon condition is called peripartum pubic symphysis disjunction (PPSD). We herein report the case of a patient with a gestational age of 38 weeks who complained of severe pain in the lumbar and pelvic region, radiating to the right hip and knee, after vaginal delivery of a single pregnancy with no obstetric complications. The patient had extensive edema and vulvar ecchymosis, and radiographic examinations showed a pubic symphysis disjunction of 7 cm and a right sacroiliac joint opening. The literature is controversial regarding the indication of treatment for these cases, but the clinical and radiographic findings motivated the surgical treatment. We closed the pubic symphysis with orthogonal plates and stabilized the sacroiliac joint with a percutaneous screw. The patient underwent outpatient follow-up for six months, with good progression and no intercurrences, and returned to work with minimal pain, good function, and satisfied with the treatment.