Department of Orthopaedics, Fortis Hospital, Kolkata, 700107, India.
Department of Orthopaedics, Sahid Laxman Nayak Medical College, Koraput, 7642020, India.
Chin J Traumatol. 2023 Jul;26(4):244-248. doi: 10.1016/j.cjtee.2021.03.008. Epub 2021 Apr 2.
A locked pubic ramus body is an unusual variant of lateral compression injury. Till date, there have been only 25 cases reported in the published literature. We herein described a case where the right pubic ramus was entrapped within the opposite obturator foramen with an overlap of greater than 4 cm, with associated urethral injury. When all maneuvers of closed and instrumented reduction failed, we performed a superior pubic ramus osteotomy on the left side and unlocked the incarcerated right pubic ramus. The osteotomy site was stabilized with a 6-hole recon plate. The patient underwent delayed urethral repair 10 weeks after the index surgery. At 3-year follow-up, the patient has sexual dysfunction especially difficulty in maintaining erection, secondary urethral stricture, heterotopic ossification, and breakage of implants.
闭孔型耻骨支骨折是一种罕见的耻骨支侧方挤压损伤的变异型。目前，文献中仅报道了 25 例此类病例。我们在此描述了一例右侧耻骨支嵌顿于对侧闭孔内，重叠超过 4cm，同时合并尿道损伤的病例。当所有闭合复位和器械复位的方法均失败后，我们在左侧耻骨支行耻骨上支切开术，解锁嵌顿的右侧耻骨支。切开部位采用 6 孔重建钢板固定。患者在指数手术后 10 周时接受了延迟性尿道修复。3 年随访时，患者出现性功能障碍，特别是勃起维持困难、继发性尿道狭窄、异位骨化和植入物断裂。
