Mid-term follow-up of superior pubic ramus osteotomy in locked symphysis pubis with urethral injury: A case report / 中华创伤杂志(英文版)

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.

Relationship between Femoroacetabular Impingement and Pubalgia in Professional Soccer Players / Relação do impacto femoroacetabular e pubalgia em jogadores profissionais de futebol de campo

Abstract Objective To analyze the relationship between pubalgia and femoroacetabular impingement (FAI) in professional athletes of a soccer club, defining the prevalence of these conditions in the sample studied. Methods It is an epidemiological, cross-sectional, and analytical study including 90 professional soccer players active from 2019 to 2021. We accessed the medical records of the subjects to retrieve information from the modified Pre-Competition Medical Assessment (PCMA) protocol, orthopedic physical examination, and anteroposterior pelvic radiographs to assess pubalgia and FAI, respectively. Inclusion criteria were athletes playing in the professional soccer club in the 2019 to 2021 season, who underwent a modified PCMA upon admission, and who signed an informed consent form. Results FAI was highly prevalent (85.6%) in the sample. This prevalence may occur because, in Brazil, people start playing sports early, not always in suitable fields, or with no proper equipment and supervision. In addition, the CAM-type impingement was the most frequent (62.2%). These injuries are related to high-intensity movements, including those associated with soccer. Furthermore, there is no dependency correlation between pubalgia and FAI. FAI was present in only 20% of athletes with pubalgia complaints. Conclusion There was a high prevalence of FAI in professional soccer players in the studied population (85.6%) but with no relationship between FAI and pubalgia.

Resumo Objetivo Analisar a relação entre a pubalgia e o impacto femoroacetabular (IFA) em atletas profissionais de um clube de futebol, definindo a prevalência de pubalgia e de impacto femoroacetabular na casuística estudada. Métodos É um estudo epidemiológico, transversal e analítico. Foram selecionados 90 atletas profissionais de futebol atuantes no período de 2019-2021. Foram acessados os prontuários para obtenção do protocolo PCMA modificado, além de exame físico ortopédico e de radiografias da bacia com incidência anteroposterior para avaliação de pubalgia e IFA, respectivamente. Critérios de Inclusão: Atletas que atuaram no clube de futebol de campo profissional na temporada de 2019 a 2021, que foram submetidos a aplicação do PCMA modificado na admissão e que assinaram o TCLE. Resultados O IFA apresentou elevada prevalência na amostra (85.6%), o que pode ocorrer pois, no Brasil, os jovens iniciam a prática esportiva em idade muito precoce, além do fato de os jogadores nem sempre praticarem o esporte em campos adequados ou com equipamentos e supervisão adequada. Ademais, o impacto tipo CAM foi o mais frequente (62.2%). O surgimento dessas lesões é relacionado a movimentos de alta intensidade, como os vistos no futebol. Outrossim, observou-se que não há correlação de dependência entre a pubalgia e o IFA. Foi visto que o IFA estava presente em apenas 20% dos atletas queixosos de pubalgia. Conclusão Há elevada prevalência de IFA em atletas de futebol profissional na população estudada (85.6%) e não houve relação entre o IFA e a presença de pubalgia.

Osteomielitis de pubis. Reporte de caso / Osteomyelitis pubis. Case report

La osteomielitis de pubis es una enfermedad infrecuente (<2% de todas las infecciones óseas) que rara vez se sospecha y su diagnóstico suele pasarse por alto, se la confunde fácilmente con pubalgias que no responden al tratamiento. Consideramos que la comunicación de este caso puede serle útil al traumatólogo para no olvidar este cuadro extremadamente infrecuente y disminuir el costo del diagnóstico y el tratamiento. Nivel de Evidencia: IV

Osteomyelitis Pubis is a rare condition that represents less than 2% of bone infections. It is not usually suspected and it can be misdiagnosed, as it can be mistaken for pubalgia that does not respond to treatment. This report may be useful to other traumatologists so as not to forget this extremely rare condition and reduce the cost of diagnosis and treatment. Level of Evidence: IV

Prevalence and surgical management of pubic hypertrophy in hypospadias patients: results from a high-volume surgeon

ABSTRACT Introduction: Pubic hypertrophy, defined as an abnormal and abundant round mass of fatty tissue located over the pubic symphysis, is frequently underestimated in patients with hypospadias. We examined the prevalence of this condition, as well as the outcomes associated with its surgical treatment. Material and methods: Within 266 hypospadias patients treated at our clinic, we assessed the prevalence of pubic hypertrophy, and we schematically described the surgical steps of pubic lipectomy. Multivariable logistic regression (MLR) tested for predictors of pubic hypertrophy. Finally, separate MLRs tested for predictors of fistula and any complications after pubic lipectomy. Results: Of 266 hypospadias patients, 100 (37.6%) presented pubic hypertrophy and underwent pubic lipectomy. Patients with pubic hypertrophy more frequently had proximal hypospadias (44 vs. 7.8%), disorders of sex development (DSD) (10 vs. 0.6%), cryptorchidism (12 vs. 2.4%), and moderate (30°-60°) or severe (>60°) penile curvature (33 vs. 4.2%). In MLR, the location of urethral meatus (proximal, Odds ratio [OR]: 10.1, p<0.001) was the only significant predictor of pubic hypertrophy. Finally, pubic lipectomy was not associated with increased risk of fistula (OR: 1.12, p=0.7) or any complications (OR: 1.37, 95% CI: 0.64-2.88, p=0.4) after multivariable adjustment. Conclusions: One out of three hypospadias patients, referred to our center, presented pubic hypertrophy and received pubic lipectomy. This rate was higher in patients with proximal hypospadias suggesting a correlation between pubic hypertrophy and severity of hypospadias. Noteworthy, pubic lipectomy was not associated with increased risk of fistula or any complications.

Separación de la sínfisis púbica postparto / Postpartum separation of the pubic symphysis

La separación de la sínfisis púbica después del parto vaginal normal es rara. La etiología no es clara y se asocia con multiparidad, macrosomía, debilitamiento fisiológico de la articulación y fuerza excesiva en el área púbica. Los síntomas incluyen dolor cerca de la articulación púbica, caderas, ingle, región inferior del abdomen y parte interna de los muslos, acompañado de sensibilidad del área. Los estudios con imágenes muestran la distancia entre los huesos púbicos. El manejo médico es variable y los resultados potenciales todavía son poco comprendidos. El retraso en el diagnóstico tiene graves consecuencias para la salud de la mujer en forma aguda y a largo plazo. Se presenta una paciente de 18 años con dolor lacerante en el área púbica durante el segundo día del puerperio. Tenía antecedentes de embarazo de evolución normal y parto vaginal espontáneo, a término, con recién nacido vivo y sin complicaciones. En el examen físico había dolor moderado en la región del pubis que interfería con la marcha y los movimientos activos de ambos miembros inferiores. La radiografía pélvica anteroposterior en posición supina mostró separación anormal de la sínfisis púbica de aproximadamente 25 milímetros de extensión, sin otras anomalías óseas o congénitas. Se recomendó tratamiento conservador con recuperación a los 3 meses

Pubic symphysis separation following normal vaginal delivery is uncommon. The etiology has not been fully elucidated and is associated with multiparity, macrosomia, physiological weakening of the joint or excessive force applied to the pelvic ring. Symptoms include pain around the symphysis pubis joint, hips, groin, lower abdomen and inner thigh associated with tenderness in the affected area. Imaging studies show the distance between the pubic bones. Medical management is variable and the potential results are yet poorly understood. Delay in diagnosis carries severe acute or long-term health consequences in patients. We present a case in an 18-year-old patient who complained of shearing pain in the pubic area on postnatal day 2. Past history included a normal full term pregnancy, normal spontaneous uncomplicated vaginal delivery and live-born infant. On physical examination patient had moderate pain over the pubic region associated with difficulty in walking and active leg movements. An anteroposterior radiograph of the pelvis in a supine position revealed a pubic symphyseal separation of 25 mm, with no other bone or congenital anomalies. She was treated conservatively with complete resolution of symptoms after 3 months.

The Majority of Corona Mortis Are Small Calibre Venous Blood Vessels: A Cadaveric Study of North Indians / 대한고관절학회지

PURPOSE: Corona mortis is an abnormal arterial or venous anastomosis between the external iliac and the obturator system of vessels and may cause significant hemorrhage during pelvi-acetabular fracture surgeries, hernia repair and laparoscopic gynecological procedures. Previous studies have estimated a prevalence of corona mortis between 34% and 70%. This cadaveric study was conducted to estimate the prevalence of corona mortis in the North Indian population. MATERIALS AND METHODS: Twelve cadavers (24 hemipelvises; 11 males and 1 female) with a mean age of 68 (range, 54–82) years were included in this study. RESULTS: Corona mortis was observed in 14 hemipelvises (58.3%). A total of 19 (79.2%) vascular anastomoses of diameter greater than 1 mm were observed; 5 hemipelvises (20.8%) had corona mortis on the right side, 9 hemipelvises (37.5%) on the left side and bilateral in 5 (41.7%) cases. Two hemipelvises (8.3%) had an arterial connection. An aberrant obturator artery was observed in 1 (4.2%) hemipelvis. A venous connection was found in 14 specimens (58.3% of hemipelvises). The average distance of the connecting vein from the symphysis pubis was 41 (35–70) mm. A vessel diameter of greater than 4 mm was observed in 4/24 (16.7%) of hemipelvises. CONCLUSION: The frequency of venous corona mortis was higher than arterial corona mortis and the majority (83.3%) were small calibre ( < 4 mm). The presentation pattern and the number of arterial or venous anastomoses were different in the majority of hemipelvises and dissimilar in both hemipelvises of the same cadaver in the majority of cases.

Anastomosis entre vasos ilíacos y obturadores en la región retropúbica: estudio en cadáveres / Anastomosis among iliac vessels and obturators in the retropubic region: study in cadavers

Introducción: En las cirugías de la región retropúbica, la sección o ruptura de la anastomosis puede causar graves hemorragias de difícil control. Nuestro objetivo fue verificar la presencia o no de anastomosis arterial o venosa entre los vasos ilíacos y obturadores en la región retropúbica. Materiales y Métodos: Treinta cadáveres (14 hombres/16 mujeres; 60% de raza blanca y 40%, no blanca). Después de la disección, se verificó si había anastomosis y su distancia de la sínfisis púbica. Resultados: El 13,3% no tenía comunicación y el 86,6% tenía algún tipo de anastomosis (p <0,01), la anastomosis venosa fue la más frecuente (p <0,05). La distancia promedio entre la anastomosis y la sínfisis púbica fue de 5,7 cm. Al comparar el sexo, la anastomosis y el lado, el 57% de los hombres presentaba anastomosis en ambos lados, y el 81% y 88% de las mujeres la tenían en el lado derecho e izquierdo, respectivamente (p <0,05). Cuando se comparó la presencia de anastomosis con el lado, el 70% estaba en el derecho y el 73%, en el izquierdo (p >0,05). El 72% de los blancos y el 67% de raza no blanca tenían anastomosis (p >0,05). Conclusiones: La presencia de anastomosis es más frecuente que la ausencia y no existe diferencia significativa en cuanto al lado. Está localizada, en promedio, a 5,7 cm de la sínfisis púbica y la venosa es significativamente más frecuente. Es significativamente más frecuente en las mujeres. No hay diferencia estadística en cuanto a la presencia de anastomosis entre la raza blanca y no blanca. Nivel de Evidencia: IV

Introduction: During surgical interventions, section or rupture of the anastomosis may cause severe difficult-to-control bleeding. The aim of this study was to verify the presence or absence of arterial or venous anastomosis among iliac and obturator vessels in the retropubic region. Methods: Thirty cadavers (14 men/16 women; 60% white and 40% non-white). After dissection, the presence of anastomosis and its distance from the pubic symphysis were verified. Results: The 13.3% presented no communication and 86.6% presented some type of anastomosis (p<0.01). Venous anastomosis was more frequent (p<0.05). The mean distance from anastomosis to pubic symphysis was 5.7 cm. Regarding sex and side, 57% of male specimens presented anastomosis on both sides, while 81% and 88% of women had on the right and left side, respectively (p<0.05). Seventy percent of specimens had anastomosis on the right side and 73% on the left (p>0.05). Anastomosis was observed in 72% of whites and 67% of non-whites. Conclusions: Presence of anastomosis is more frequent than its absence, and there is no significant difference regarding side. It is located at 5.7 cm from the pubic symphysis and venous anastomosis is significantly more frequent. Anastomosis is significantly more frequent in females. There is no statistically significant difference between white and non-white races. Level of Evidence: IV

Phthirus pubis Infestation of the Scalp: A Case Report and Review of The Literature

Phthirus pubis usually infests the pubis, groin, buttocks and perianal region. It can sometimes infest the thighs, abdomen, chest, axillae and beard. Eyelashes and eyebrows may be involved in children. The involvement of the scalp is very rare. We describe a case of P. pubis infestation located exclusively on the scalp in an adult woman. Neither lice/nits nor skin lesions were observed elsewhere, including eyebrows, eyelashes, axillae, pubis, buttocks and perianal region (the patient was hairless in the axillae and pubis). A review of the literature is enclosed.

Conservative Treatment of Physeal Bar after Triradiate Cartilage Injury / 대한정형외과학회잡지

We report a patient who experienced no function problems during the 5-year follow-up after a conservative treatment for minimally displaced acetabular fracture that developed as a result of the formation of physeal bar. According to the computed tomography, triradiate cartilage was fractured and minimally displaced, which was identified as a Salter Harris type II physeal injury. A fracture of the anterior wall of the acetabulum was also observed. It was judged as a stable fracture, and conservative treatment was performed. On the follow-up x-ray, the physeal bar was formed in the damaged triradiate cartilage. At 5-year follow-up, physeal injury of the triradiate cartilage has influenced the acetabular growth, resulting in acetabular dysplasia, pelvic asymmetry, hypoplasia of pubis, and widening of the tear drop. However, anteversion and inclination of the injured acetabulum were similar with those of the contralateral side. Our patient also did not complain of any hip discomfort.

Solitary osteochondroma in the body of the pubic bone: a cadaveric case report / 대한해부학회지

Osteochondromas develop as cartilaginous nodules in the periosteum of bones. They are the commonest benign tumors of the skeleton, generally observed in the long bones. Rarely, they are also found in the axial skeleton, flat bones of skull and facial bones. During a regular dissection, we came across a solitary osteochondroma in posterior surface of the body of the right pubic bone. Histopathology of the bony projection confirmed the typical features of the osteochondroma. The symptomatic osteochondromas are usually evaluated during radiographic examination. Though, the observed osteochondroma is relatively smaller its unusual location is remarkable and knowledge of occurrence of such nodules is clinically important during the diagnosis and planning of treatment.

Application of artificial ligament in treatment of lower abdominal wall reconstruction after pubic tumor resection / 北京大学学报(医学版)

OBJECTIVE@#For patients who had hemipelvectomies involving the resection of a portion or the whole of the pubis, bony reconstruction was not recommended commonly. However, the soft tissue reconstruction of the lower abdominal wall may benefit these patients. The object of the study was to determine the clinical effect of lower abdominal wall reconstruction with LARS ligament after pubic tumor resection interms of patient-reported and objective outcome.@*METHODS@#In this series, we reviewed twenty-five patients who underwent pubic tumor resection followed by reconstruction with LARS ligament between February 2012 and February 2018 retrospectively. We evaluated the clinical outcome and complication of this surgical treatment. The function outcome was evaluated according the musculoskeletal tumor society scores (MSTS) for all the patients at the end of the last follow-up.@*RESULTS@#All the patients were stable during the surgery. There were eight patients who underwent resection of superior ramus of pubis, five patients who had resection of inferior ramus of pubis, and twelve patients who received both superior and inferior ramus of pubis. For all the patients, the mean blood loss was (774±580) mL. The mean operation time was (138±25) min. The mean hospital stay was (19±6) d. For the patients who had resection of superior ramus, inferior ramus, as well as both superior and inferior ramus, the mean blood loss were (763±802) mL, (730±315) mL and (808±485) mL, respectively. The mean operation time were (133±27) min, (135±35) min and (143±20) min, respectively. The mean hospital stay were (18±5) d, (22±9) d and (19±6) d, respectively. The mean follow-up time was (37±21) months. Local recurrence was observed in one patient with chondrosarcoma. One patient with renal cancer metastasis died of the disease. No ligament infection, ligament related complication and incisional hernias were observed. Twenty-three patients could ambulate without assistive devices, and the remaining two could walk by crutches. Postoperative pain was reported as none in nineteen patients, mild in three, and moderate in three. From a functional point, the mean MSTS score was 87±4.@*CONCLUSION@#Lower abdominal wall reconstruction with LARS ligament after pubic tumor resection could have satisfactory clinical outcome. It could prevent the occurrence of herniation, decrease the infection rate by minishing the dead space, and achieve good patient-reported outcome.

Uretroplastia transpúbica como tratamiento de la estenosis de uretra proximal compleja: resultados de una intervención interdisciplinaria / Transpubic Urethroplasty as a Treatment of Complex Proximal Urethral Stricture: Results of an Interdisciplinary Intervention

La uretroplastia transpúbica es una técnica empleada para tratar la estenosis de uretra proximal compleja, permitiendo una mejor visualización del campo quirúrgico y una mayor facilidad al momento de realizar la anastomosis. Existen pocas descripciones en la literatura de los resultados quirúrgicos y funcionales en los pacientes sometidos a ese procedimiento, el propósito de este estudio es describir una serie de casos complejos tratados con ese abordaje, de una manera interdisciplinaria entre Urología y Ortopedia

Transpubic urethroplasty is a technique used to treat complex proximal urethral stricture, allowing better visualization of the surgical field and greater ease at the time of performing the anastomosis. There are few descriptions in the literature of the surgical and functional results in the patients undergoing this procedure, the purpose of this study is to describe a series of complex cases treated with this approach, in an interdisciplinary way between Urology and Orthopedics.

Location of the umbilicus in Korean women and its changes after breast reconstruction with an ipsilateral pedicled rectus abdominis musculocutaneous flap

BACKGROUND: The umbilicus makes an important contribution to the natural appearance of the abdomen. To date, studies on its position in Korean women are lacking, and no standards have been established. The purpose of this study was to investigate the position of umbilicus in Korean women and to review changes in its position after ipsilateral pedicled rectus abdominis musculocutaneous (IP-RAM) flap. METHODS: This research consisted of two studies. In first study, 100 females who visited the emergency department with gastroenteritis between 2007 and 2011 were included. In second study, 40 women who underwent IP-RAM flap in the same period were included. Using abdominal computed tomography, we measured the distance between xiphoid process and umbilicus, represented by value a, and the distance between umbilicus and symphysis pubis, represented by value b. Thus, the location of the umbilicus was represented by the ratio a/b. The data were analyzed using Pearson correlation test and paired t-test. RESULTS: In study 1, the mean value of a/b was 1.07. Pearson correlation test revealed a significant correlation between age and a/b. In study 2, the mean value of a/b was 1.16 in preoperative measurements and 1.01 in postoperative measurements. The paired t-test showed a significant difference between preoperative and postoperative measurements, indicating cephalic migration of the umbilicus after surgery. CONCLUSIONS: The natural position of the umbilicus showed caudal migration with aging. Additionally, in a comparison of preoperative and postoperative measurements in patients who underwent IP-RAM flap, cephalic migration of the umbilicus was observed after surgery.

Idiopathic central precocious puberty: A case report / Philippine Journal of Obstetrics and Gynecology

@#<p style="text-align: justify;">Central precocious puberty is characterized by early pubertal changes, acceleration of growth velocity, and rapid bone maturation. It is a relatively rare disorder, with an incidence rate of about 1:5000-1:10000 individuals in the general population; it is more frequent in girls than in boys. This is a case of a 7 year-old female complaining of onset of menstruation. Physical examination revealed advanced pubertal changes of Tanner stage 4-5 for breast and stage 3 for pubis. Diagnostic evaluation revealed well developed internal genitalia, markedly elevated LH levels, advanced bone aging and a normal cranial MRI. Based on clinical and diagnostic evaluations, a diagnosis of idiopathic central precocious puberty was made and the patient was started on GnRha therapy. It is important to initiate therapy early in patients with central precocious puberty so as to prevent compromised adult height and psychosocial embarrasment</p>

Aneurysmal bone cyst of ischiopubic ramus: a rare location with literature review

Aneurysmal bone cyst [ABC] is a locally destructive lesion of the bone rather than a true neoplasm. The pelvis is not an unusual site for an ABC; approximately 12% of cases occur in this location. We present a case of aneurysmal bone cyst [ABC] in ischiopubic ramus in a 22 years old male who presented with right inguinal swelling and pain. He was evaluated with X-ray and Magnetic Resonance Imaging MRI of pelvis. A review of literature regarding this rare site of ABC with radiological features is also described in this case report. ABC of ischiopubic ramus is an uncommon entity hence diagnosis of such a case requires proper clinical, radiological and histopathological evaluation to rule out other differential diagnoses of an expansile, osteolytic lesion. This will help in selecting a proper treatment plan

Visible Angle on Magnetic Resonance Imaging Can Be Considered Indicator of Postoperative Outcome in Retropubic Radical Prostatectomy

PURPOSE: We aimed to measure the visible angle (VA) outside the surgical field of view using preoperative magnetic resonance imaging (MRI), and to relate structural data to clinical outcome. MATERIALS AND METHODS: We retrospectively analyzed data obtained from 322 consecutive patients who underwent robot-assisted laparoscopic radical prostatectomy (RALP) or radical retropubic prostatectomy (RRP) for prostate cancer from January 2011 to June 2013, with at least 1 year of follow-up. Patients were divided into 4 groups, according to median VA values and surgical approach. VA was defined as the angle between the horizontal line on view, rotated to 90∘ from the midsagittal T2-weighted sequence image, and the tangent line of the highest protruding surface of the symphysis pubis. RESULTS: The larger VA was, the shorter mean operative time (213.2 minutes vs. 174.2 minutes, p=0.002) was significantly and the smaller VA was, the higher complication rate (10.8% vs. 1.6%, p=0.043) was in RRP patients. There were no significant differences in operative outcomes in RALP patients. CONCLUSIONS: VA in midsagittal T2-weighted sequence predict operative time and complication rates in retropubic radical prostatectomy, and thus, the value may be used as surgical indications for retropubic radical prostatectomy.

Pelvic Insufficiency Fracture in Severe Osteoporosis Patient / 대한고관절학회지

PURPOSE: To evaluate clinical features and the effect of parathyroid hormone (PTH) on treatment outcomes of patients with pelvic insufficiency fractures. MATERIALS AND METHODS: Fifteen patients diagnosed with pelvic insufficiency fractures were evaluated retrospectively. All patients had osteoporosis with mean lumbar T score of −3.9 (range, −3.1 to −6.4) and the mean age was 76.5 years. In all cases, simple radiography and computed tomography was used for final diagnosis; additional magnetic resonance imaging and technetium bone scans were used to confirm the diagnosis in 2 and 6 patients, respectively. Initial conservative treatment was used in all cases; treatment with PTH was applied in 5 cases. Radiological follow-up was done every 4 weeks up to 6 months and every 3 months thereafter. Symptom improvement was measured using visual analogue scale (VAS) score. RESULTS: Fractures were located: i) sacrum and pubis (9 cases), ii) isolated sacrum (4 cases) and iii) isolated pubis (2 cases). One case showed fracture displacement and pain aggravation at 4 week follow-up which was treated with percutaneous sacro-iliac fixation using cannulated screws. Duration of bone union was significantly shorter in the patients who used PTH (P<0.05). VAS scores were also lower in the group treated with PTH; however, statistical significance was not reached. CONCLUSION: In patients with osteoporosis, a pelvic insufficiency fracture should be considered if pain is experienced in the pelvic area in the absence of major trauma. While nonoperatic has been shown to be sufficient for treatment, our study shows that PTH therapy shortens treatment period and could be a favorable treatment option.

Outcome of Internal Fixation and Corticocancellous Grafting of Symphysis Pubis Diastasis Which Developed after Malunion of Pubic Rami Fracture / 대한고관절학회지

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.

Idiopathic central precocious puberty: A case report / Philippine Journal of Obstetrics and Gynecology

Central precocious puberty is characterized by early pubertal changes, acceleration of growth velocity, and rapid bone maturation. It is a relatively rare disorder, with an incidence rate of about 1:5000-1:10000 individuals in the general population; it is more frequent in girls than in boys. This is a case of a 7 year-old female complaining of onset of menstruation. Physical examination revealed advanced pubertal changes of Tanner stage 4-5 for breast and stage 3 for pubis. Diagnostic evaluation revealed well developed internal genitalia, markedly elevated LH levels, advanced bone aging and a normal cranial MRI. Based on clinical and diagnostic evaluations, a diagnosis of idiopathic central precocious puberty was made and the patient was started on GnRha therapy. It is important to initiate therapy early in patients with central precocious puberty so as to prevent compromised adult height and psychosocial embarrasment

Osteítis infecciosa del pubis. A propósito de un caso / Infectious osteitis pubis. A propos of a case

Se presenta un caso de osteitis del pubis por Staphylococcus aureus, en un varón de 30 años y tratado exitosamente con linezolid y levofloxacina.

We describe a case o infectious osteitis pubis in one male patient of 30 years. The patient had favorable clinical course after treament with linezolid and levofloxacin.