Bombaci Hasan
Department of Orthopaedics and Traumatology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
Hip Pelvis. 2017 Jun;29(2):150-153. doi: 10.5371/hp.2017.29.2.150. Epub 2017 Jun 2.
We report a case of pubic symphysis diastasis, which was initially asymptomatic; however, it became symptomatic with urinary incontinence during pregnancy. The patient was treated with open reduction and internal fixation of the symphysis pubis. A corticocancellous autograft was used for filling the gap which remained despite bilateral compression of the iliac bones. We obtained satisfactory outcome in terms of symptoms at the 3 years' follow-up; however, there was instability findings in the X-rays with broken screws. We conclude that asymptomatic pubic symphysis diastasis might be symptomatic after additional trauma (such as pregnancy) in the following days, if it was unstable in the very beginning of injury. Fixation of old pubic symphysis diastasis with reconstruction plate by filling the gap by using corticocancellous autograft, might not prevent ultimate implant failure if the symphysis pubis diastasis is part of an unstable pelvic fracture in the very beginning.
我们报告一例耻骨联合分离病例，该病例最初无症状；然而，在怀孕期间出现了尿失禁症状。患者接受了耻骨联合切开复位内固定治疗。尽管对髂骨进行了双侧加压，但仍有间隙，使用了皮质松质自体骨移植来填充该间隙。在3年的随访中，我们在症状方面取得了满意的结果；然而，X线检查发现螺钉断裂，存在不稳定表现。我们得出结论，如果耻骨联合分离在损伤初期就不稳定，那么无症状的耻骨联合分离在随后的日子里（如怀孕等）受到额外创伤后可能会出现症状。如果耻骨联合分离从一开始就是不稳定骨盆骨折的一部分，通过使用皮质松质自体骨移植填充间隙并用重建钢板固定陈旧性耻骨联合分离，可能无法防止最终的植入物失败。
