Locked pubic symphysis with ipsilateral fracture neck of a femur

Percutaneous Treatment of Locked Pubic Symphysis with the Anterior Subcutaneous Pelvic Fixator (INFIX): A Case Report

CASE

A 54-year-old woman was involved in a motor vehicle collision and sustained a lateral compression type 1 pelvic ring fracture with pubic symphyseal dislocation or a "locked pubic symphysis." Her injury failed to reduce with closed reduction maneuvers under anesthesia and necessitated a percutaneous reduction using a distraction force applied through supra-acetabular placed pedicle screws. This anterior subcutaneous internal pelvic fixator (INFIX) was also used to stabilize the injury.

CONCLUSION

This is the first reported case where a locked pubic symphysis, which failed standard closed reduction measures, was reduced and stabilized through a percutaneous technique, using the INFIX.

Locked pubis symphysis in a skeletally immature patient, a case report

Background

Locked symphysis pubis is an exceedingly rare pelvic injury especially in the paediatric population. This study is the first to describe this fracture in a skeletally immature patient.

Case report

We report the case of a fifteen year old boy who presented to the Emergency Department (ED) after being involved in a farming injury with a left lateral compression pelvic trauma. He sustained Locked Symphysis Pubis (LSP) and internal pelvic bleeding from the right Internal Iliac Artery (IIA). He was treated successfully by selective embolization of the ILA followed by closed reduction of the LSP and percutaneous fixation of the SI joint.

Conclusion

Locked symphysis pubis in the paediatric population is an exceedingly rare injury among lateral compression type pelvic fractures. Careful assessment and preoperative management planning are encouraged. Open packing of the pelvis in case of internal bleeding should be avoided in paediatric patients, only selective embolization is advocated. Closed reduction of the LSP by using the external fixator as a lever arm for reduction followed by percutaneous fixation of the SI joint. Moreover, changing the patient position to prone position followed by posterior lumbar spine stabilisation is our preferred method of treatment.

Locked book pubic symphysis: A case report in a resource-limited setting in sub-Sahara Africa

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Locked pubic symphysis is a serious injury of the pelvis.

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Very few cases has been reported in the literature.

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This nosological entity shows peculiarities in its manually difficult reduction and associated complications.

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A good outcome can be obtained after management with simple gestures, possible even in ressource-limited settings.

Introduction

Locked pubic symphysis is a rare but serious injury that occurs by lateral compression mechanism. It is an overlapping pubic symphysis dislocation, with one pubic bone entrapped behind the contralateral pubis, locked into the contralateral obturator foramen.

Case report

We report the case of a 25 years old male who presented with acute urine retention following a left lateral compression pelvic trauma by a motor vehicle and was diagnosed with a locked pubic symphysis treated successfully by open reduction and combined internal and external fixation.

Conclusion

Locked pelvic symphysis is a rare form of pelvic injury. The majority of cases require stabilization by open reduction and internal fixation of the anterior pelvic ring. Urogenital injuries are the commonest associated injuries, despite unfavourable mechanism.

Posterior locked lateral compression injury of the pelvis in geriatric patients: an infrequent and specific variant of the fragility fracture of pelvis

INTRODUCTION

Posterior locked lateral compression injury (PLLCI) of the pelvic ring is an infrequent variant of lateral compression injury, a condition described in only eight reported cases since 2000. Lateral compression injury usually results from high-energy trauma and is characterized by locking between the medially translated fractured ilium and the anterior border of the sacrum, regardless of whether the fractured ilium involves the sacroiliac joint. However, in our experience, lateral compression injury can also result from low-energy trauma as a manifestation of pelvic fragility fracture. The aim of the present study was to describe this rare form of PLLCI in a case series of geriatric patients.

METHODOLOGY

A retrospective analysis of consecutive patients with pelvic ring injuries who were admitted to our hospital from January 2008 to April 2015 identified seven geriatric patients (1 male and 6 females; median age 81 years) with a form of PLLCI.

RESULTS

All injuries were due to falls from a standing position onto the ground. All seven cases demonstrated characteristics of a locking fractured ilium over the anterior border of the sacrum on axial computed tomography images, but were not detected on plain radiographs. All underwent follow-up at 1 year or later with improved mean visual analogue scale scores (range 0-3). Regarding Koval walking ability scores, patients who underwent pelvic brim plating with anterior external fixation were more likely to regain their pre-injury walking ability than patients who only underwent anterior external fixation or conservative treatment.

CONCLUSION

Geriatric patients can experience PLCCIs of the pelvis due to low-energy trauma. These fractures have different characteristics from those associated with severe injuries due to high-energy trauma, and they comprise an infrequent form of Rommens fragility fracture of the pelvis (type IIIa). In these cases, appropriate surgical management that includes sacroiliac plating combined with anterior external fixation can yield good outcomes.

Overlapping Dislocation of the Pubic Symphysis with an Open Reduction and Anterior and Posterior Pelvic Ring Fixation: A Case Report

CASE

We present a case of a patient who sustained overlapping dislocation of the pubic symphysis (ODPS), which required an open reduction as well as anterior and posterior pelvic ring fixation.

CONCLUSION

This case report is a valuable addition to the current literature on ODPS because we believe it to be the first report describing a patient who required both anterior and posterior fixation because of pelvic instability.

Locked pubic symphysis into the obturator foramen: a rare case presentation and literature review

Locked pubic symphysis is a rare form of pelvic injury. It occasionally occurs after a lateral compression injury of the pelvis. We described an overlapping pubic symphysis dislocation that was locked into the contralateral obturator foramen. To the best of our knowledge, there are about seventeen similar cases reported in the literature. The pubic symphysis was finally reduced by means of a superior pubic ramus osteotomy to unlock the incarcerated pubic body out of the contralateral obturator foramen. As the reduction was unstable, the pubic symphysis was fixed with a reconstruction plate. The patient recovered completely and returned to normal activities within 4months. At 1year's follow-up she reported no discomfort in the pubic symphysis region and was able to void urine normally.

Case report: locked pubic symphysis: an open reduction technique

A locked pubic symphysis occasionally occurs after a lateral compression injury of the pelvic ring. One pubic bone becomes entrapped behind the contralateral pubis. Lateral compression pelvic injuries are well recognized, but a lateral compression pelvic injury resulting in a locked pubic symphysis is rare. We describe a locked pubic symphysis with greater than 4 cm overlap that was reduced with simple maneuvers and readily available instruments.

Overlapping dislocation of the pubic symphysis: report of three cases and review of the literature

We present three cases of overlapping pubic symphysis dislocation and revise all the fully reported similar ones in the literature. The mechanism of injury, clinical presentation, radiographic assessment, associated injuries, management and complications of this uncommon injury are discussed.