Overview
Fracture of the pubic tubercle is a rare injury often associated with significant trauma, typically affecting the attachment sites of muscles around the pubic symphysis. It can lead to instability and pain in the pelvic region 2.Diagnosis
Clinical Presentation: Pain localized to the pubic region, potential instability indicated by clicking sensations 3.
Imaging: MRI is valuable for detailed assessment, particularly in athletes, showing pubic bone marrow oedema and other structural changes 1.
Radiographic Findings: Marginal irregularity, reactive sclerosis, and instability may be observed on radiographs 3.Management
Nonoperative Treatment: Rest from physical exertion is recommended as the most effective initial treatment 3.
Surgical Intervention: Open reduction and internal fixation may be necessary in cases where nonoperative means fail to achieve or maintain reduction 2.Special Populations
Athletes: Repeated minor trauma is a primary aetiological factor; spontaneous remission is common with rest 3.
No specific guidance provided for pregnancy, pediatrics, elderly, or comorbidities based on the given abstracts.Key Recommendations
Initiate Rest from Physical Activity to alleviate symptoms and promote healing (Evidence: Moderate) 3.
Consider MRI for Detailed Assessment in athletes or cases with persistent symptoms to evaluate structural changes accurately (Evidence: Moderate) 1.
Surgical Intervention may be required for patients who do not respond to nonoperative management, particularly for maintaining reduction (Evidence: Weak) 2.References
1 Branci S, Thorborg K, Bech BH, Boesen M, Magnussen E, Court-Payen M et al.. The Copenhagen Standardised MRI protocol to assess the pubic symphysis and adductor regions of athletes: outline and intratester and intertester reliability. British journal of sports medicine 2015. link
2 Lewis MM, Mayer V. Pubic symphysis diastasis treated by open reduction and internal fixation. Clinical orthopaedics and related research 1977. link
3 Harris NH, Murray RO. Lesions of the symphysis in athletes. British medical journal 1974. link