BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are e...BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent.Notwithstanding,patients with copious comorbidities should be carefully monitored for potential vascular injury.CASE SUMMARY This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture.The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission,necessi-tating urgent intervention.A computed tomography angiography revealed active bleeding,leading to the embolization of the medial femoral branch.The patient was stabilized hemodynamically and was discharged after 15 days,with recom-mendations for home-based follow-up care.CONCLUSION This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively,but need prompt monitoring for occult vascular injuries that can be fatal.展开更多
Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective...Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective cohort study included 45 patients with APRFs treated between February 2019 and October 2022 in our trauma center.Patients were divided into two groups based on the surgical method:20 received RPRIN fixation,and 25 received PCS fixation.Key variables including operation time,fluoroscopic time,blood loss,and postoperative complications were analyzed.Fracture reduction quality was assessed using the Matta score system,and pelvic functional recovery was evaluated using the Majeed score system at the final follow-up.Quantitative variables were compared using the independent sample t test,while categorical variables were analyzed using Chisquare and Fisher’s exact tests.Results The RPRIN group had significantly shorter operation time(36.3±5.6 min vs.49.5±6.9 min,P<0.01),fluoroscopic time(32.0±2.8 s vs.48.4±3.6 s,P<0.01),and less blood loss(20.4±7.6 mL vs.34.0±5.7 mL,P<0.01)than the PCS group.Fracture reduction quality(Matta outcome)and pelvic functional recovery(Majeed outcome)were comparable between the two groups(P>0.05).No significant complications were reported in either group.Conclusions Both RPRIN and PCS are effective for treating APRFs.However,RPRIN offers distinct advantages by reducing operation time,fluoroscopic time,and blood loss,making it a more efficient and less invasive option.Further multicenter studies and biomechanical analyses are warranted to confirm these findings.展开更多
Symphyseal dissection results from high-energy trauma and usually occurs in poly trauma context. The treatment is only orthopedic in our department. The aim of this work was to study the current therapeutic aspects ma...Symphyseal dissection results from high-energy trauma and usually occurs in poly trauma context. The treatment is only orthopedic in our department. The aim of this work was to study the current therapeutic aspects management of the disjunction of the pubic symphysis in the department of ortho-traumatology of CHU Gabriel Touré of Bamako MALI. This was a prospective and analytical study;from 1 July 2021 to 30 June 2022, within 15 patients classified according to Young and Burgess, with a functional evaluation according to Majeed and a minimum follow-up of 4 months. We report symphyseal disconnections accounted for 20.83% of the traumas of the pelvic ring, and 1.84% of patients hospitalized for fracture in the department during the period of the study. We noted a predominance of gender male in 87% of cases with a ratio of 2.75 and the average age in our series was 32 years, with extremes ranging from 18 to 63 and a SD of 13.96. The most common etiologies are APR with 66.7% and traditional mine slide cases with 20%, and the anteroposterior compression mechanism is most frequently encountered at 73.3%. The APCI types: 20%, APCII: 40% and VC: 20% of the Young and Burgess classification are the most found. The treatment of these patients was surgical in 53% cases by locked screw plate. The surgical approach of Pfannenstiel was preferred to the ilio-inguinal of Judet. Non-surgical treatment by trans-osseous traction and the wearing of a pelvic belt was recommended for cases of stable disjunction or severe associated lesions. The average length of stay is 17.27 days with extremes of 5 and 34 days. The functional assessment according to Majeed allowed us to classify 73.3% of patients’ cases as excellent, showing a good socio-professional reintegration. Symphyseal disjunction is a rare pathology but of serious functional consequences, regardless of the therapeutic method good management allows to minimize these functional sequelae.展开更多
Pubic hair removal has increased in frequency over recent years, with some degree of pubic hair grooming considered desirable by both men and women. Despite the increasing use of chemical depilatory creams for the rem...Pubic hair removal has increased in frequency over recent years, with some degree of pubic hair grooming considered desirable by both men and women. Despite the increasing use of chemical depilatory creams for the removal of hair in intimate regions, there is a lack of published data regarding the safety and efficacy of such products when used for full hair removal in the genital area. This study investigated the in-use cutaneous compatibility of two thioglycolate chemical depilatory creams for full male and female genital depilation through three single application studies. Initially, a preliminary study tested a standard male intimate chemical depilatory cream (Product A) on 18 male participants to ensure acceptable tolerance of the product. Following this, Study 1 applied Product A to 33 male participants whilst a standard female intimate chemical depilatory cream (Product B) was applied to 31 female participants in Study 2. Visual dermal assessments, together with participant-perceived assessment of tolerance, were conducted before application, and at 30 minutes, 24 and 72 hours after product removal. Study 1 reported 5 incidences (out of 33) of dermal irritation at 30 minutes post product removal, with 3 incidences remaining after 72 hours post product removal. Study 2 reported 4 incidences (out of 31) of dermal irritation at 30 minutes post product removal with 1 incidence remaining after 72 hours post product removal. Both chemical depilatory creams were concluded by a dermatologist, on the basis of dermal irritation and participant-perceived tolerance, to have achieved acceptable dermal tolerance when applied to the intended area of use for the maximum recommended application time. This data provides confidence in the safety of chemical depilatory creams when used for full removal of the pubic hair of men and women and adds to the existing published database, validating the safety and efficacy of these products for genital hair removal.展开更多
BACKGROUND Widening of the pubic joint of more than 10 mm is diagnostic and defined as pubic symphysis diastasis and is considered a complication of vaginal childbirth or pregnancy.As it is a rare pathology(ranging fr...BACKGROUND Widening of the pubic joint of more than 10 mm is diagnostic and defined as pubic symphysis diastasis and is considered a complication of vaginal childbirth or pregnancy.As it is a rare pathology(ranging from 1 in 300 to 1 in 30000 pregnancies),no gold standard treatment has been defined.CASE SUMMARY This study examines two cases,a 27-year-old woman(gravida 1,para 1)and a 32-year-old woman(gravida 2,para 2),who presented to the clinic after uneventful vaginal deliveries.A normal pregnancy with no complications was observed in both patients.Severe pain in the pubic region occurred after labour and was accompanied by complicated locomotion.Pubic symphysis diastasis was confirmed radiologically and bed rest with lateral decubitus positioning was recommended.Oral non-steroidal antiinflammatory drugs were administered to relieve pain exacerbations.The symptoms decreased after treatment.Posttreatment magnetic resonance imaging(MRI)in the first case showed a reduction in symphyseal separation with no signs of osteitis.Three years later the symptoms recurred;MRI examination showed no further symphyseal widening or signs of osteitis.A relapse of symphyseal separation was diagnosed and conservative treatment was re-administered resulting in successful recovery.In the second case,pain recurred when the patient conceived for the second time.This time no benefit following conservative treatment was observed.Persistent pain and complicated locomotion led to scoliotic deformation of the lumbar part of the spine and leg length discrepancy,thus surgical treatment was chosen and internal pubic synthesis was performed.CONCLUSION Overall,surgical treatment resulting from insufficient conservative treatment showed a high risk of postoperative complications following the treatment of postpartum pubic symphysis diastasis.展开更多
BACKGROUND Separation of the pubic symphysis can occur during the peripartum period.Relaxin(RLX)is a hormone primarily secreted by the corpus luteum that can mediate hemodynamic changes during pregnancy as well as loo...BACKGROUND Separation of the pubic symphysis can occur during the peripartum period.Relaxin(RLX)is a hormone primarily secreted by the corpus luteum that can mediate hemodynamic changes during pregnancy as well as loosen the pelvic ligaments.However,it is unknown whether RLX is associated with peripartum pubic symphysis separation and if the association is affected by other factors.AIM To study the association between RLX and peripartum pubic symphysis separation and evaluate other factors that might affect this association.METHODS We performed a cross-sectional study of pregnant women between April 2019 and January 2020.Baseline demographic characteristics,including gestational age,weight,neonatal weight,delivery mode and duration of the first and second stages of labor,were recorded.The clinical symptoms were used as a screening index during pregnancy,and the patients with pubic symphysis and inguinal pain were examined by color Doppler ultrasonography to determine whether there was pubic symphysis separation.Serum RLX concentrations were evaluated 1 d after delivery using an enzyme-linked immunosorbent assay,and pubic symphysis separation was diagnosed based on postpartum X-ray examination.We used an independent-sample t test to analyze the association between serum RLX levels and peripartum pubic symphysis separation.Multivariate regression analysis was used to evaluate whether the association between RLX and peripartum pubic symphysis separation was confounded by other factors,and the association between RLX and the severity of pubic symphysis separation was also assessed.We used Pearson correlation analysis to determine the factors related to RLX levels as well as the correlation between the degree of pubic symphysis separation and activities of daily living(ADL)and pain.RESULTS A total of 54 women were enrolled in the study,with 15 exhibiting(observational group)and 39 not exhibiting(control group)peripartum pubic symphysis separation.There were no statistically significant differences in terms of maternal age,gestational age,pre-pregnancy weight,weight gain during pregnancy,delivery modes,or duration of the first or second stages of labor between the 2 groups.We did,however,note a statistically significant difference in serum RLX concentrations and neonatal weight between the observational and control groups(122.3±0.7μg/mL vs 170.4±42.3μg/mL,P<0.05;3676.000±521.725 g vs 3379.487±402.420 g,P<0.05,respectively).Multivariate regression analyses showed that serum RLX level[odds ratio(OR):1.022)and neonatal weight(OR:1.002)were associated with pubic symphysis separation peripartum.The degree of separation of the pubic symphysis was negatively correlated with ADL and positively correlated with pain.There was no statistically significant association between serum RLX levels and the severity of pubic symphysis separation after adjusting for confounding factors.CONCLUSION Serum RLX levels and neonatal weight were associated with the occurrence,but not the severity,of peripartum pubic symphysis separation.展开更多
Background: The pubic region is often involved in accidental hot water or soup-spill burns. Most of these wounds are superficial partial thickness burns. Due to their proximity to the urinary system, as well as vagina...Background: The pubic region is often involved in accidental hot water or soup-spill burns. Most of these wounds are superficial partial thickness burns. Due to their proximity to the urinary system, as well as vaginal and anal openings,these burns are easily contaminated. Daily dressings are routinely prescribed as the sole treatment. The cumbersome dressing process is uncomfortable and embarrassing for patients. Biobrane^(TM) is a bilayered biosynthetic dressing. Its coverage of superficial partial thickness burns promotes wound healing and allows one-time application.Case presentations: We report two patients who suffered superficial dermal burns over their pubic region. One patient had 23% total body surface area(TBSA) burns over her lower abdomen, both thighs and pubic region. The second patient had 10% TBSA burns that involved her perineum and the medial sides of both thighs and buttocks.Both were managed with the standard resuscitation protocol in the initial phase. Their burn injuries were managed by shaving, Foley catheterization and Biobrane^(TM) coverage. Their wounds healed uneventfully without complications.Full epithelization was achieved by post-operative day seven. Both patients consented to medical photography and academic publication.Conclusions: Shaving and catheterization improved the hygiene of the burns of the pubic area. The Biobrane^(TM)method circumvents the need of regular dressing changes, eliminating the pain due to dressing changes and preserving patient dignity.展开更多
A new method for curing the pubic symphsis separation is presented in this paper. The site of the pubic symphysis was injected with 1% lidocain,chymotrypsin,prednisolone;and some peroral drugs were administrated at th...A new method for curing the pubic symphsis separation is presented in this paper. The site of the pubic symphysis was injected with 1% lidocain,chymotrypsin,prednisolone;and some peroral drugs were administrated at the same time.And the disease could be cured in a week by using the therapy,with an excellent effect without relapse.展开更多
Background: Postoperative pubic or ischial stress fracture may be a complication after curved periacetabular osteotomy (CPO). The discontinuity of the superior pubic rami is a risk factor for this complication. We inv...Background: Postoperative pubic or ischial stress fracture may be a complication after curved periacetabular osteotomy (CPO). The discontinuity of the superior pubic rami is a risk factor for this complication. We investigated the stress field differences in standing and sitting positions after CPO. Methods: We used finite element analysis to assess the effects of inferior pubic rami and ischial fractures with or without discontinuity of superior pubic rami. We used the “union model”, obtained from a bony union at the osteotomy site of the superior pubic rami from 38-year-old woman who had undergone CPO for left hip dysplasia. We deleted the bony union region and created a discontinuity in the superior pubic rami equal to the non-union, creating the “discontinuity model”. We compared the stress field and stress value in the simulated standing and half weight-bearing positions on the operative side, one-legged standing position on the non-operative side, and the sitting position. Findings: In 4 cases, the inferior rami experienced the highest stress. Stress values in the discontinuity model were higher than those in the union model: 1.7 times in the case of one-legged standing on the operative side, 2.4 times in the case of half weight-bearing on the operative side, 3.8 times in the case of one-legged standing on the non-operative side, and 2.0 times in the sitting position, respectively. Interpretation: We recommend patients delay weight bearing on the operative side, avoid the sitting position as long as possible, and sit down slowly to prevent inferior pubic rami and ischial fractures after CPO.展开更多
Pubic symphysiolysis and retroperitoneal arterial vessel rupture after bareback horse riding is a rare traumatic combination. We report a case of a 59-year-old man who experienced severe pubic, abdominal and lower bac...Pubic symphysiolysis and retroperitoneal arterial vessel rupture after bareback horse riding is a rare traumatic combination. We report a case of a 59-year-old man who experienced severe pubic, abdominal and lower back pain due to a bounce after a asynchronous rhythm of horseback riding without a saddle. The patient was referred to our Emergency Department because of a suspected ruptured abdominal aortic aneurysm. Computer tomography demonstrated diastasis of the pubic symphysis, active bleeding of a branch of the left internal iliac artery and a massive retroperitoneal haematoma. The arterial bleeding was directly coiled in the emergency setting, the stable pubic symphysiolysis was treated conservatively and the haematoma was surgically drained after three days. Bareback horse riding can lead to a pelvic fracture and severe bleeding leading to haemodynamical instability and life threatening situations. Using proper protective equipment including a saddle to prevent equestrian injury should be emphasized.展开更多
Study objective： to verify if the PAA （angle of the pubic arch） is a predictive data for the mode of delivery, the duration of labour and the expulsion period. Methods： we chose to measure the PAA in 100 women rec...Study objective： to verify if the PAA （angle of the pubic arch） is a predictive data for the mode of delivery, the duration of labour and the expulsion period. Methods： we chose to measure the PAA in 100 women recruited, chosen from the 38th to the 42th week of gestation. The method involves the use of two-dimensional transperineal ultrasound. Data collection took place over a period of time from May to September 2015. The ante-partum data taken into consideration were the patient’s name and surname, PAA, parity, age, height; those acquired in the post-partum provide for the calculation in minutes of the active phase of labor, the duration of the expulsion period, the execution of the amniorrhexis and the use of the synthetic oxytocin, the fetal cranial circumference, the fetal weight and the position of the presented part. Results： results discovered ultrasoundly 100 PAA, with an average value of 115.5° and we proceeded by evaluating 90 vaginal births. Infants at birth had a CC with an average value of 34.5 mm. By relating the two variables PAA and CC for the dependent variable “period expulsion in minutes”, confirming that the expulsive period depends on the relationship between PAA and CC. The average of the minutes of the expulsion period is 50＇ in women with a PAA 〉 111.5° and a CC 〉 34.5 mm while in women with an PAA 〉 111.5° the media time is 30＇ regardless of the CC. It has been shown that oxytocin and amniorrhexis reduce the minutes of the expulsion period only in a case of PAA 〉 111.5° and a CC 〉 34.5 mm bringing them from 60＇ to 23＇. Conclusion： the duration of the active phase of labor is not influenced by the PAA but it depends on external factors. In the case of the expulsion period, a predictability of the PAA on its duration is shown if the CC is taken into consideration; as regards the influence of the PAA on the method of delivery, it was not possible to carry out any analysis since all the useful cases had vaginal delivery.展开更多
Background: Pubic symphysis diastasis (PSD) is an uncommon complication of labor and delivery. Common risk factors of PSD include precipitous labor, rapid second stage of labor, intense uterine contractions, prior pel...Background: Pubic symphysis diastasis (PSD) is an uncommon complication of labor and delivery. Common risk factors of PSD include precipitous labor, rapid second stage of labor, intense uterine contractions, prior pelvic pathology, multiparity and macrosomia. Diagnosis is made clinically and confirmed by imaging. Management of PSD depends on the severity of symptoms and degree of symphysis separation. Standard therapy is conservative, but surgery may be needed in severe cases. Case Report: A 25-year-old female at term pregnancy presented in active labor and had a rapid second stage of labor without intravenous oxytocin or an epidural. She was subsequently diagnosed with severe PSD with a 5.5 cm separation. Her management included a pelvic binder, pain management, physical therapy, and serial imaging to monitor improvement. Discussion: In severe cases, surgery can be avoided in favor of conservative measures for the management of PSD. Multidisciplinary involvement with orthopedic surgery, radiology, physical therapy, and anesthesiology can play a vital role in optimal management. PSD may recur in future deliveries, but this does not preclude vaginal birth.展开更多
In order to promote China to take part in the activities of international standardization and improve the standardization level of China, Mr. Oliver Smoot, President of ISO, made a public speech on international stand...In order to promote China to take part in the activities of international standardization and improve the standardization level of China, Mr. Oliver Smoot, President of ISO, made a public speech on international standardization of the global economy at the invitation of SAC (Standardization Administration of China) on Nov. 1st.展开更多
Objective: to explore the application effect of low frequency electrical stimulation pulse intervention combined with manual massage nursing in postpartum pubic combined separation. Methods: 58 postpartum combined pub...Objective: to explore the application effect of low frequency electrical stimulation pulse intervention combined with manual massage nursing in postpartum pubic combined separation. Methods: 58 postpartum combined pubic bone separation women admitted from June 2019 to December 2021 were selected and grouped by clinic order number. Control group: conventional intervention, observation group: low-frequency electrical stimulation pulse intervention and manual massage intervention. The nursing effect, pain score, pubic joint distance, quality of life, satisfaction, and clinical indicators were observed. Results: the total effectiveness of the observation group and the control group was, respectively, as follows: 96.55%, 79.31%, and P < 0.05. The corresponding data of pain score and pubic distance in the observation group were all smaller after the intervention, P < 0.05. The observation group each quality of life index was higher by intervention than the control group, P < 0.05. The total satisfaction rates of the observation group and the control group were, respectively: 96.55%, 75.86%, and P < 0.05. The hospitalization and ambulation were shorter than the control group, P < 0.05. Conclusion: the intervention of low-frequency electrical stimulation pulse is helpful to accelerate the speed of maternal rehabilitation, and is important to relieve the pain and optimize the quality of life. The corresponding effect is good, and the overall prognosis is relatively optimistic. This method is worthy of further praise and development.展开更多
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 ent...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 per-formed 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.展开更多
Intramuscular hemangioma usually involues only a single muscle,but it may demonstrate regional involvement and can occasionally grow extremely large.In the latter condition,resection can be very difficult and occasion...Intramuscular hemangioma usually involues only a single muscle,but it may demonstrate regional involvement and can occasionally grow extremely large.In the latter condition,resection can be very difficult and occasionally lead to fatal uncontrollable bleeding during surgery.展开更多
目的探讨阴部神经阻滞术联合肛门内括约肌切断术在混合痔术后的镇痛效果。方法前瞻性选取2022年2月至2024年12月期间华南理工大学第六附属医院收治的200例混合痔患者作为研究对象。按照随机数字表法将其分为4组:阴部神经阻滞组、肛门括...目的探讨阴部神经阻滞术联合肛门内括约肌切断术在混合痔术后的镇痛效果。方法前瞻性选取2022年2月至2024年12月期间华南理工大学第六附属医院收治的200例混合痔患者作为研究对象。按照随机数字表法将其分为4组:阴部神经阻滞组、肛门括约肌切断组、肛周亚甲蓝封闭组、阴部神经阻滞+肛门括约肌切断组,每组各50例。比较4组手术时间、住院时间、创面愈合时间,术后6、12、72、96 h视觉模拟评分法(VAS),肛管静息压、肛管最大收缩压、并发症发生率。结果与阴部神经阻滞组、肛门括约肌切断组、肛周亚甲蓝封闭组比较,阴部神经阻滞+肛门括约肌切断组住院时间、创面愈合时间均显著降低,差异均有统计学意义(P<0.05)。与阴部神经阻滞组、肛门括约肌切断组、肛周亚甲蓝封闭组比较,阴部神经阻滞+肛门括约肌切断组术后6、12、72、96 h VAS评分均显著降低,差异均有统计学意义(P<0.05)。与阴部神经阻滞组、肛周亚甲蓝封闭组比较,肛门括约肌切断组、阴部神经阻滞+肛门括约肌切断组肛管静息压均显著降低,肛管最大收缩压均显著增高,差异均有统计学意义(P<0.05)。4组并发症发生率比较,差异无统计学意义(P>0.05)。结论阴部神经阻滞术联合肛门内括约肌切断术治疗混合痔可优化围手术期指标,降低患者术后疼痛,有利于保护肛门功能,且不会增加并发症发生风险,应当给予关注。展开更多
文摘BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent.Notwithstanding,patients with copious comorbidities should be carefully monitored for potential vascular injury.CASE SUMMARY This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture.The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission,necessi-tating urgent intervention.A computed tomography angiography revealed active bleeding,leading to the embolization of the medial femoral branch.The patient was stabilized hemodynamically and was discharged after 15 days,with recom-mendations for home-based follow-up care.CONCLUSION This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively,but need prompt monitoring for occult vascular injuries that can be fatal.
基金supported by Clinical Application-oriented Medical Innovation Foundation from National Clinical Research Center for Orthopedics,Sports Medicine&Rehabilitation and Jiangsu China-Israel Industrial Technical Research Institute Foundation(No.2021-NCRC-CXJJ-ZH-24)National Key R&D Plan of the 14th Five-Year Plan(No.2022YFC2504303).
文摘Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective cohort study included 45 patients with APRFs treated between February 2019 and October 2022 in our trauma center.Patients were divided into two groups based on the surgical method:20 received RPRIN fixation,and 25 received PCS fixation.Key variables including operation time,fluoroscopic time,blood loss,and postoperative complications were analyzed.Fracture reduction quality was assessed using the Matta score system,and pelvic functional recovery was evaluated using the Majeed score system at the final follow-up.Quantitative variables were compared using the independent sample t test,while categorical variables were analyzed using Chisquare and Fisher’s exact tests.Results The RPRIN group had significantly shorter operation time(36.3±5.6 min vs.49.5±6.9 min,P<0.01),fluoroscopic time(32.0±2.8 s vs.48.4±3.6 s,P<0.01),and less blood loss(20.4±7.6 mL vs.34.0±5.7 mL,P<0.01)than the PCS group.Fracture reduction quality(Matta outcome)and pelvic functional recovery(Majeed outcome)were comparable between the two groups(P>0.05).No significant complications were reported in either group.Conclusions Both RPRIN and PCS are effective for treating APRFs.However,RPRIN offers distinct advantages by reducing operation time,fluoroscopic time,and blood loss,making it a more efficient and less invasive option.Further multicenter studies and biomechanical analyses are warranted to confirm these findings.
文摘Symphyseal dissection results from high-energy trauma and usually occurs in poly trauma context. The treatment is only orthopedic in our department. The aim of this work was to study the current therapeutic aspects management of the disjunction of the pubic symphysis in the department of ortho-traumatology of CHU Gabriel Touré of Bamako MALI. This was a prospective and analytical study;from 1 July 2021 to 30 June 2022, within 15 patients classified according to Young and Burgess, with a functional evaluation according to Majeed and a minimum follow-up of 4 months. We report symphyseal disconnections accounted for 20.83% of the traumas of the pelvic ring, and 1.84% of patients hospitalized for fracture in the department during the period of the study. We noted a predominance of gender male in 87% of cases with a ratio of 2.75 and the average age in our series was 32 years, with extremes ranging from 18 to 63 and a SD of 13.96. The most common etiologies are APR with 66.7% and traditional mine slide cases with 20%, and the anteroposterior compression mechanism is most frequently encountered at 73.3%. The APCI types: 20%, APCII: 40% and VC: 20% of the Young and Burgess classification are the most found. The treatment of these patients was surgical in 53% cases by locked screw plate. The surgical approach of Pfannenstiel was preferred to the ilio-inguinal of Judet. Non-surgical treatment by trans-osseous traction and the wearing of a pelvic belt was recommended for cases of stable disjunction or severe associated lesions. The average length of stay is 17.27 days with extremes of 5 and 34 days. The functional assessment according to Majeed allowed us to classify 73.3% of patients’ cases as excellent, showing a good socio-professional reintegration. Symphyseal disjunction is a rare pathology but of serious functional consequences, regardless of the therapeutic method good management allows to minimize these functional sequelae.
文摘Pubic hair removal has increased in frequency over recent years, with some degree of pubic hair grooming considered desirable by both men and women. Despite the increasing use of chemical depilatory creams for the removal of hair in intimate regions, there is a lack of published data regarding the safety and efficacy of such products when used for full hair removal in the genital area. This study investigated the in-use cutaneous compatibility of two thioglycolate chemical depilatory creams for full male and female genital depilation through three single application studies. Initially, a preliminary study tested a standard male intimate chemical depilatory cream (Product A) on 18 male participants to ensure acceptable tolerance of the product. Following this, Study 1 applied Product A to 33 male participants whilst a standard female intimate chemical depilatory cream (Product B) was applied to 31 female participants in Study 2. Visual dermal assessments, together with participant-perceived assessment of tolerance, were conducted before application, and at 30 minutes, 24 and 72 hours after product removal. Study 1 reported 5 incidences (out of 33) of dermal irritation at 30 minutes post product removal, with 3 incidences remaining after 72 hours post product removal. Study 2 reported 4 incidences (out of 31) of dermal irritation at 30 minutes post product removal with 1 incidence remaining after 72 hours post product removal. Both chemical depilatory creams were concluded by a dermatologist, on the basis of dermal irritation and participant-perceived tolerance, to have achieved acceptable dermal tolerance when applied to the intended area of use for the maximum recommended application time. This data provides confidence in the safety of chemical depilatory creams when used for full removal of the pubic hair of men and women and adds to the existing published database, validating the safety and efficacy of these products for genital hair removal.
文摘BACKGROUND Widening of the pubic joint of more than 10 mm is diagnostic and defined as pubic symphysis diastasis and is considered a complication of vaginal childbirth or pregnancy.As it is a rare pathology(ranging from 1 in 300 to 1 in 30000 pregnancies),no gold standard treatment has been defined.CASE SUMMARY This study examines two cases,a 27-year-old woman(gravida 1,para 1)and a 32-year-old woman(gravida 2,para 2),who presented to the clinic after uneventful vaginal deliveries.A normal pregnancy with no complications was observed in both patients.Severe pain in the pubic region occurred after labour and was accompanied by complicated locomotion.Pubic symphysis diastasis was confirmed radiologically and bed rest with lateral decubitus positioning was recommended.Oral non-steroidal antiinflammatory drugs were administered to relieve pain exacerbations.The symptoms decreased after treatment.Posttreatment magnetic resonance imaging(MRI)in the first case showed a reduction in symphyseal separation with no signs of osteitis.Three years later the symptoms recurred;MRI examination showed no further symphyseal widening or signs of osteitis.A relapse of symphyseal separation was diagnosed and conservative treatment was re-administered resulting in successful recovery.In the second case,pain recurred when the patient conceived for the second time.This time no benefit following conservative treatment was observed.Persistent pain and complicated locomotion led to scoliotic deformation of the lumbar part of the spine and leg length discrepancy,thus surgical treatment was chosen and internal pubic synthesis was performed.CONCLUSION Overall,surgical treatment resulting from insufficient conservative treatment showed a high risk of postoperative complications following the treatment of postpartum pubic symphysis diastasis.
基金The Science and Technology Development Plan of Taian,No.2018NS0203.
文摘BACKGROUND Separation of the pubic symphysis can occur during the peripartum period.Relaxin(RLX)is a hormone primarily secreted by the corpus luteum that can mediate hemodynamic changes during pregnancy as well as loosen the pelvic ligaments.However,it is unknown whether RLX is associated with peripartum pubic symphysis separation and if the association is affected by other factors.AIM To study the association between RLX and peripartum pubic symphysis separation and evaluate other factors that might affect this association.METHODS We performed a cross-sectional study of pregnant women between April 2019 and January 2020.Baseline demographic characteristics,including gestational age,weight,neonatal weight,delivery mode and duration of the first and second stages of labor,were recorded.The clinical symptoms were used as a screening index during pregnancy,and the patients with pubic symphysis and inguinal pain were examined by color Doppler ultrasonography to determine whether there was pubic symphysis separation.Serum RLX concentrations were evaluated 1 d after delivery using an enzyme-linked immunosorbent assay,and pubic symphysis separation was diagnosed based on postpartum X-ray examination.We used an independent-sample t test to analyze the association between serum RLX levels and peripartum pubic symphysis separation.Multivariate regression analysis was used to evaluate whether the association between RLX and peripartum pubic symphysis separation was confounded by other factors,and the association between RLX and the severity of pubic symphysis separation was also assessed.We used Pearson correlation analysis to determine the factors related to RLX levels as well as the correlation between the degree of pubic symphysis separation and activities of daily living(ADL)and pain.RESULTS A total of 54 women were enrolled in the study,with 15 exhibiting(observational group)and 39 not exhibiting(control group)peripartum pubic symphysis separation.There were no statistically significant differences in terms of maternal age,gestational age,pre-pregnancy weight,weight gain during pregnancy,delivery modes,or duration of the first or second stages of labor between the 2 groups.We did,however,note a statistically significant difference in serum RLX concentrations and neonatal weight between the observational and control groups(122.3±0.7μg/mL vs 170.4±42.3μg/mL,P<0.05;3676.000±521.725 g vs 3379.487±402.420 g,P<0.05,respectively).Multivariate regression analyses showed that serum RLX level[odds ratio(OR):1.022)and neonatal weight(OR:1.002)were associated with pubic symphysis separation peripartum.The degree of separation of the pubic symphysis was negatively correlated with ADL and positively correlated with pain.There was no statistically significant association between serum RLX levels and the severity of pubic symphysis separation after adjusting for confounding factors.CONCLUSION Serum RLX levels and neonatal weight were associated with the occurrence,but not the severity,of peripartum pubic symphysis separation.
文摘Background: The pubic region is often involved in accidental hot water or soup-spill burns. Most of these wounds are superficial partial thickness burns. Due to their proximity to the urinary system, as well as vaginal and anal openings,these burns are easily contaminated. Daily dressings are routinely prescribed as the sole treatment. The cumbersome dressing process is uncomfortable and embarrassing for patients. Biobrane^(TM) is a bilayered biosynthetic dressing. Its coverage of superficial partial thickness burns promotes wound healing and allows one-time application.Case presentations: We report two patients who suffered superficial dermal burns over their pubic region. One patient had 23% total body surface area(TBSA) burns over her lower abdomen, both thighs and pubic region. The second patient had 10% TBSA burns that involved her perineum and the medial sides of both thighs and buttocks.Both were managed with the standard resuscitation protocol in the initial phase. Their burn injuries were managed by shaving, Foley catheterization and Biobrane^(TM) coverage. Their wounds healed uneventfully without complications.Full epithelization was achieved by post-operative day seven. Both patients consented to medical photography and academic publication.Conclusions: Shaving and catheterization improved the hygiene of the burns of the pubic area. The Biobrane^(TM)method circumvents the need of regular dressing changes, eliminating the pain due to dressing changes and preserving patient dignity.
文摘A new method for curing the pubic symphsis separation is presented in this paper. The site of the pubic symphysis was injected with 1% lidocain,chymotrypsin,prednisolone;and some peroral drugs were administrated at the same time.And the disease could be cured in a week by using the therapy,with an excellent effect without relapse.
文摘Background: Postoperative pubic or ischial stress fracture may be a complication after curved periacetabular osteotomy (CPO). The discontinuity of the superior pubic rami is a risk factor for this complication. We investigated the stress field differences in standing and sitting positions after CPO. Methods: We used finite element analysis to assess the effects of inferior pubic rami and ischial fractures with or without discontinuity of superior pubic rami. We used the “union model”, obtained from a bony union at the osteotomy site of the superior pubic rami from 38-year-old woman who had undergone CPO for left hip dysplasia. We deleted the bony union region and created a discontinuity in the superior pubic rami equal to the non-union, creating the “discontinuity model”. We compared the stress field and stress value in the simulated standing and half weight-bearing positions on the operative side, one-legged standing position on the non-operative side, and the sitting position. Findings: In 4 cases, the inferior rami experienced the highest stress. Stress values in the discontinuity model were higher than those in the union model: 1.7 times in the case of one-legged standing on the operative side, 2.4 times in the case of half weight-bearing on the operative side, 3.8 times in the case of one-legged standing on the non-operative side, and 2.0 times in the sitting position, respectively. Interpretation: We recommend patients delay weight bearing on the operative side, avoid the sitting position as long as possible, and sit down slowly to prevent inferior pubic rami and ischial fractures after CPO.
文摘Pubic symphysiolysis and retroperitoneal arterial vessel rupture after bareback horse riding is a rare traumatic combination. We report a case of a 59-year-old man who experienced severe pubic, abdominal and lower back pain due to a bounce after a asynchronous rhythm of horseback riding without a saddle. The patient was referred to our Emergency Department because of a suspected ruptured abdominal aortic aneurysm. Computer tomography demonstrated diastasis of the pubic symphysis, active bleeding of a branch of the left internal iliac artery and a massive retroperitoneal haematoma. The arterial bleeding was directly coiled in the emergency setting, the stable pubic symphysiolysis was treated conservatively and the haematoma was surgically drained after three days. Bareback horse riding can lead to a pelvic fracture and severe bleeding leading to haemodynamical instability and life threatening situations. Using proper protective equipment including a saddle to prevent equestrian injury should be emphasized.
文摘Study objective： to verify if the PAA （angle of the pubic arch） is a predictive data for the mode of delivery, the duration of labour and the expulsion period. Methods： we chose to measure the PAA in 100 women recruited, chosen from the 38th to the 42th week of gestation. The method involves the use of two-dimensional transperineal ultrasound. Data collection took place over a period of time from May to September 2015. The ante-partum data taken into consideration were the patient’s name and surname, PAA, parity, age, height; those acquired in the post-partum provide for the calculation in minutes of the active phase of labor, the duration of the expulsion period, the execution of the amniorrhexis and the use of the synthetic oxytocin, the fetal cranial circumference, the fetal weight and the position of the presented part. Results： results discovered ultrasoundly 100 PAA, with an average value of 115.5° and we proceeded by evaluating 90 vaginal births. Infants at birth had a CC with an average value of 34.5 mm. By relating the two variables PAA and CC for the dependent variable “period expulsion in minutes”, confirming that the expulsive period depends on the relationship between PAA and CC. The average of the minutes of the expulsion period is 50＇ in women with a PAA 〉 111.5° and a CC 〉 34.5 mm while in women with an PAA 〉 111.5° the media time is 30＇ regardless of the CC. It has been shown that oxytocin and amniorrhexis reduce the minutes of the expulsion period only in a case of PAA 〉 111.5° and a CC 〉 34.5 mm bringing them from 60＇ to 23＇. Conclusion： the duration of the active phase of labor is not influenced by the PAA but it depends on external factors. In the case of the expulsion period, a predictability of the PAA on its duration is shown if the CC is taken into consideration; as regards the influence of the PAA on the method of delivery, it was not possible to carry out any analysis since all the useful cases had vaginal delivery.
文摘Background: Pubic symphysis diastasis (PSD) is an uncommon complication of labor and delivery. Common risk factors of PSD include precipitous labor, rapid second stage of labor, intense uterine contractions, prior pelvic pathology, multiparity and macrosomia. Diagnosis is made clinically and confirmed by imaging. Management of PSD depends on the severity of symptoms and degree of symphysis separation. Standard therapy is conservative, but surgery may be needed in severe cases. Case Report: A 25-year-old female at term pregnancy presented in active labor and had a rapid second stage of labor without intravenous oxytocin or an epidural. She was subsequently diagnosed with severe PSD with a 5.5 cm separation. Her management included a pelvic binder, pain management, physical therapy, and serial imaging to monitor improvement. Discussion: In severe cases, surgery can be avoided in favor of conservative measures for the management of PSD. Multidisciplinary involvement with orthopedic surgery, radiology, physical therapy, and anesthesiology can play a vital role in optimal management. PSD may recur in future deliveries, but this does not preclude vaginal birth.
文摘In order to promote China to take part in the activities of international standardization and improve the standardization level of China, Mr. Oliver Smoot, President of ISO, made a public speech on international standardization of the global economy at the invitation of SAC (Standardization Administration of China) on Nov. 1st.
文摘Objective: to explore the application effect of low frequency electrical stimulation pulse intervention combined with manual massage nursing in postpartum pubic combined separation. Methods: 58 postpartum combined pubic bone separation women admitted from June 2019 to December 2021 were selected and grouped by clinic order number. Control group: conventional intervention, observation group: low-frequency electrical stimulation pulse intervention and manual massage intervention. The nursing effect, pain score, pubic joint distance, quality of life, satisfaction, and clinical indicators were observed. Results: the total effectiveness of the observation group and the control group was, respectively, as follows: 96.55%, 79.31%, and P < 0.05. The corresponding data of pain score and pubic distance in the observation group were all smaller after the intervention, P < 0.05. The observation group each quality of life index was higher by intervention than the control group, P < 0.05. The total satisfaction rates of the observation group and the control group were, respectively: 96.55%, 75.86%, and P < 0.05. The hospitalization and ambulation were shorter than the control group, P < 0.05. Conclusion: the intervention of low-frequency electrical stimulation pulse is helpful to accelerate the speed of maternal rehabilitation, and is important to relieve the pain and optimize the quality of life. The corresponding effect is good, and the overall prognosis is relatively optimistic. This method is worthy of further praise and development.
文摘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 per-formed 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.
文摘Intramuscular hemangioma usually involues only a single muscle,but it may demonstrate regional involvement and can occasionally grow extremely large.In the latter condition,resection can be very difficult and occasionally lead to fatal uncontrollable bleeding during surgery.
文摘目的探讨阴部神经阻滞术联合肛门内括约肌切断术在混合痔术后的镇痛效果。方法前瞻性选取2022年2月至2024年12月期间华南理工大学第六附属医院收治的200例混合痔患者作为研究对象。按照随机数字表法将其分为4组:阴部神经阻滞组、肛门括约肌切断组、肛周亚甲蓝封闭组、阴部神经阻滞+肛门括约肌切断组,每组各50例。比较4组手术时间、住院时间、创面愈合时间,术后6、12、72、96 h视觉模拟评分法(VAS),肛管静息压、肛管最大收缩压、并发症发生率。结果与阴部神经阻滞组、肛门括约肌切断组、肛周亚甲蓝封闭组比较,阴部神经阻滞+肛门括约肌切断组住院时间、创面愈合时间均显著降低,差异均有统计学意义(P<0.05)。与阴部神经阻滞组、肛门括约肌切断组、肛周亚甲蓝封闭组比较,阴部神经阻滞+肛门括约肌切断组术后6、12、72、96 h VAS评分均显著降低,差异均有统计学意义(P<0.05)。与阴部神经阻滞组、肛周亚甲蓝封闭组比较,肛门括约肌切断组、阴部神经阻滞+肛门括约肌切断组肛管静息压均显著降低,肛管最大收缩压均显著增高,差异均有统计学意义(P<0.05)。4组并发症发生率比较,差异无统计学意义(P>0.05)。结论阴部神经阻滞术联合肛门内括约肌切断术治疗混合痔可优化围手术期指标,降低患者术后疼痛,有利于保护肛门功能,且不会增加并发症发生风险,应当给予关注。
