Department of Orthopaedics, Medical Trust Hospital, Cochin, Kerala, India.
Department of Urology, Medical Trust Hospital, Cochin, Kerala, India.
JBJS Case Connect. 2020 Apr-Jun;10(2):e0196. doi: 10.2106/JBJS.CC.19.00196.
An 18-year-old adolescent sustained a lateral compression injury to the pelvis that featured a locked pubic symphysis with plastic deformation of the sacrum. The pubic bone was entrapped in the opposite obturator foramen and required a novel distraction osteotomy of the superior ramus to restore the symphysis. The patient developed a urethral stricture 3 months after injury that required urethroplasty. The symphysis remained in alignment without any morbidity at the osteotomy site over 13 months of follow-up.
Locked pubic symphysis is frequently associated with urethral injuries. The distraction osteotomy of the superior pubic ramus described is a viable reduction maneuver that neutralizes the plastic deformation forces.
一名 18 岁青少年的骨盆遭受侧方挤压伤，耻骨联合处闭锁且伴有骶骨塑性变形。耻骨骨块嵌顿于对侧闭孔，需要通过耻骨上支新型骨切开术牵开以恢复耻骨联合。该患者在损伤后 3 个月发生尿道狭窄，需要行尿道成形术。随访 13 个月时，耻骨联合在骨切开部位没有任何并发症，保持在对线位置。
耻骨联合闭锁常合并尿道损伤。描述的耻骨上支骨切开术牵开是一种可行的复位手段，可中和塑性变形力。
