Stress fractures of the pubic ramus. A report of twelve cases

Twelve stress fractures of the pubic arch were seen in eleven patients who were joggers, long-distance runners, or marathoners. In two of the fractures there were complications of healing; that is, delayed union or refracture. With two exceptions, the lesions occurred in women between the ages of nineteen and forty-eight. In all of the patients the fracture was in the inferior pubic ramus near the symphysis pubis, and caused pain in the groin, buttock, or thigh. All fractures were non-displaced and easy to overlook on the initial radiographic examination; when a fracture of the pubic arch was clinically suspected but the radiographs were normal, a radionuclide bone scan was diagnostic. After identification of the fracture, running had to be curtailed until the symptoms disappeared in order for healing to occur.