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CC BY 4.0 · Rev Bras Ortop (Sao Paulo)
DOI: 10.1055/s-0043-1776023
Relato de Caso

Surgical Treatment of Peripartum Pelvic Ring Injury: Case Report

Article in several languages: português | English
Ewerton Borges de Souza Lima 
1   Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Marco Antonio Rojas Janco 
1   Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Ubiratan Stefani de Oliveira Saturnino 
1   Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Tarcísio Alves Leal 
1   Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Fernando Baldy dos Reis 
1   Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Luiz Fernando Cocco 
1   Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
› Author Affiliations Financial Support The authors declare that they have received no financial support from public, private, or not-for-profit sources to conduct the present study.
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Abstract

During the gestational period, the pubic symphysis dilates for vaginal delivery. However, exacerbated widening may indicate ligament injury and pelvic instability, resulting in significant pain complaints. This uncommon condition is called peripartum pubic symphysis disjunction (PPSD). We herein report the case of a patient with a gestational age of 38 weeks who complained of severe pain in the lumbar and pelvic region, radiating to the right hip and knee, after vaginal delivery of a single pregnancy with no obstetric complications. The patient had extensive edema and vulvar ecchymosis, and radiographic examinations showed a pubic symphysis disjunction of 7 cm and a right sacroiliac joint opening. The literature is controversial regarding the indication of treatment for these cases, but the clinical and radiographic findings motivated the surgical treatment. We closed the pubic symphysis with orthogonal plates and stabilized the sacroiliac joint with a percutaneous screw. The patient underwent outpatient follow-up for six months, with good progression and no intercurrences, and returned to work with minimal pain, good function, and satisfied with the treatment.

Keywords

gestation - joint instability - pelvic bones - postpartum period - pubic symphysis - sacroiliac joint

Work developed at the Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.




Publication History

Received: 29 November 2022

Accepted: 07 February 2023

Article published online:
22 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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