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At least 19 recordsLinked to original sources

[The use of childbirth alterations of the pubic bone for identification (author's transl)].

This paper discusses whether parturition or the number of parturition events can be determined from certain gross alterations, which are caused by pregnancy and parturition, found around the symphysis area of the pubic bone. The study is based on the analysis of 49 pairs of pubic bones, for which the number of parturitions and/or abortions were known. No criteria were found to be useful for a clear forensic diagnosis. However, this investigation did show a certain probability of correlation between the extension of grooves on the posterior pubic cortex and the number of parturitions. Examples of remarkable misleading conclusions in special cases are given.

Adult

The morphology of European and Southwest Asian Neandertal pubic bones.

Descriptions of Southwest Asian Neandertal os coxae have stressed the supero-inferior flattening and acetabulo-symphyseal elongation of the superior pubic rami. Further analysis of Neandertal pubes, including two European specimens. La Ferrassie I and Krapina 208, indicates that Neandertal pubes are distinguished primarily by a relative elongation of the superior rami. The supero-inferior flattening of the pubic rami with the formation of a distinct ventral border, present among the Southwest Asian Neandertals, is less pronounced among the European Neandertals. Neither sexual dimorphism nor biomechanical hypertrophy appears adequate to explain this morphological pattern of Neandertal pubic bones.

Asia, Western

Bladder exstrophy and anterior pelvic osteotomy.

Between August 1988 and December 1991, 36 children with bladder exstrophy underwent surgery for primary bladder reconstruction. Each child was either untreated or had already been treated unsuccessfully. The operative technique involved bilateral osteotomy of the superior ramus of the pubic bone. In infants the cartilaginous ischiopubic junction, acting as an articulation, allowed symphyseal approximation, while in older children this was achieved by fracture of the inferior ramus of the pubic bone. The bladder was either closed or, in most cases, the exstrophic bladder plate was inserted deep into the pelvis, allowing subsequent epithelialisation of the bladder and further formation and growth. Follow-up up for 3.5 years showed bladder capacities of 40 to 150 ml. Some patients underwent an additional augmentation enterocystoplasty. Primary bladder reconstruction remained uncompromised in 7 patients who developed moderate (and 1 complete) rediastasis of the pubic bones. All exstrophic bladders are reconstructible, particularly in older children.

Bladder Exstrophy

Acute pubic osteomyelitis in athletes.

Three cases of pubic osteomyelitis in athletes are reported. The clinical presentation in each case was acute groin, hip, or perineal pain; fever; chills; inability to bear weight; and pubic symphysis tenderness. Since radiographic changes in the pubic bone can be delayed, a high index of suspicion is required by the clinician. Although Staphylococcus aureus is the dominant pathogen in pubic osteomyelitis, it is recommended that the diagnosis be established by culture of blood or pubic bone aspirate so that specific therapy can be instituted quickly.

Acute Disease

Oxandrolone treatment of constitutional short stature in boys during adolescence: effect on linear growth, bone age, pubic hair, and testicular development.

Seventeen constitutionally short boys were studied throughout puberty. Nine received oxandrolone (0.1 mg/kg/day). Treatment was started before onset of puberty. Eight boys served as control subjects. No significant increase in linear growth or skeletal maturation was observed in the treated group. Likewise the peak height velocity was unchanged. Pubic hair developed similarly in both groups in relation to chronologic and skeletal age. The only significant difference was a diminution in testicular volume index during treatment after bone age of 12 years and until bone age of 14 6/12 years.

Adolescent

Transpubic repair of vesicourethrovaginal fistula.

A patient with recurrent urinary vaginal fistula involving bladder, bladder neck, and urethra was treated by transpubic approach. This afforded excellent exposure for careful repair of the urologic defects. Difficulty with ambulation during the first few weeks postoperatively may be related to removal of larger segment of pubic bone than is usually reported.

Evaluation Studies as Topic

["Chronic inguinal strain" in top-athletes and its treatment (author's transl)].

The picture of "chronic inguinal strain" must be regarded as a further development of the "gracilis-syndrome" described by Schneider in 1964 (posttraumatic pibic osteonecrosis). These are rupture of the tendons of gracilis and adductor-longus, degenerated at their points of insertion on the pubic bone. Only surgery is successful. As described by Schneider, the tendon is divided and osteonecrotic tissue removed. If there is rupture the necrotic part of the tendon is excised, the remainder suture red to the nearby tendon. Re-fixation of the tendon at the pubic bone is unnecessary because of the very monor adduction-function of gracilis. Return to sport will be possible-on average-after 6-8 weeks.

Adult

Clinical study of malignant tumors originating in the pelvic region.

We evaluated the surgical problems encountered during treatment of 14 patients with malignant tumors originating in the pelvic region at our department. The tumor involved the iliac bone in 6 patients, the ischial bone in 2, the pubic bone in 2, and the gluteal region in 4. Invasion to the sacrum was observed in 7 patients. Twelve patients underwent surgical procedures consisting of intralesional resection in 6, marginal resection in 3, and wide margin resection in 3. Six of the 7 patients with sacral invasion developed local recurrence. Two patients with chondrosarcoma and one with parosteal osteosarcoma survived for 4 or more years, but the mean survival period in those with high grade malignant tumors was 11 months. These findings indicate the difficulties encountered in the treatment of malignant pelvic tumors.

Adolescent

[A rare röntgenographie finding in an infant pelvis (author's transl)].

In a total of 6857 pelvic X-rays of infants, 7 cases were observed showing two variants of cleft formation in the upper ramus of the pubic bone. While these clefts are not indicative of a morbid condition, they might lead to wrong diagnosis. The changes in question are due to the rare occurrence and delayed union, of two centres of ossification in the area of the os pubis.

Age Factors

A light and electron microscopic study of a hemangiopericytoma of the prostate with local extension.

A case of primary hemangiopericytoma of the prostate is reported. The patient presented with obstructive uropathy and was diagnosed as "benign prostatic hypertrophy." A transurethral resection was done and was diagnosed as "cellular leiomyoma." Obstructive symptoms recurred and skin and pubic bone involvement appeared 2 months later. Light and electron microscopy of the repeat transurethral resection and biopsy of the perineal mass confirmed the diagnosis of hemangiopericytoma of the prostate.

Basement Membrane

A re-examination of parturition scars on the human female pelvis.

Pits, cavities and depressions located on the dorsal surface of the pubic symphysis of females have been attributed to the trauma of parturition. Earlier research based on human skeletal remains provides inadequate information on the individual's obstetrical history. The 68 female pubic bones that were studied had comprehensive medical records indicating whether or not each female had given birth. Fourteen and one-half percent of the females who had not given birth exhibited trace to small scarring of the pubic symphysis and 23.4% of the females who had not given birth exhibited medium to large scarring. It is suggested that bony changes previously used as an indicator of child bearing must be re-examined in light of the fact that "birth scarring" has been found in women known not to have had children.

Female

Problems in the aging of females using the Os pubis.

The Gilbert-McKern method for aging the female Os pubis has attained popularity following Gilbert's ('73) demonstration that the McKern-Stewart male standards are not directly applicable to females. In order to assess the reliability of the method, forensic anthropologists were asked to age a set of 11 pubes of known age. There was a great deal of variability in the responses of the 23 participants. Three, four, and five different responses (out of a 6-scale system) were given for each component of each pubic bone. Only 51% of the assessments yielded age ranges which would include the known age of the specimens. Analysis of the errors showed that one of the focal problems of the Gilbert-McKern system was the difficulty in judging whether the ventral rampart was building up or breaking down.

Adolescent

Transpubic urethroplasty.

Eleven patients underwent transpubic repair of membranous urethral strictures. Excision of the wedge of pubic bone was not associated with orthopedic disability and provided excellent exposure for primary anastomosis of the urethra. Distal urethral mobilization and incision of the intercrural septum provided adequate urethral length for tension-free anastomosis. Satisfactory results were achieved in all patients, without adversely affecting continence or potency.

Adolescent

Improved exposure for excision of rectal carcinomas: initial experiences with a pubic resection technique.

Preliminary experiences with a transpubic approach for carcinoma of the rectum are described. By excising a wedge of pubic bone and freeing the left lateral attachments of the bladder, the entire length of rectum can be exposed, down to the level of the levator muscles. Dissection of the tumor can be performed under direct vision, even in unfavorable anatomic and pathologic situations. Low rectal anastomoses, at levels of 1--2 cm above the anus, may be performed with greater ease. It is felt that urinary problems should be uncommon and that orthopedic complications should not occur since sacroiliac articulations are not disturbed by retraction.

Aged

Anchor fixation and other modifications of endoscopic bladder neck suspension.

The long-term efficacy of surgical treatment of stress urinary incontinence can be improved by modifications that reduce the possibility of suspending suture detachment. Fifty-three women with stress urinary incontinence underwent consecutive endoscopic bladder neck suspensions with new modifications developed in an effort to decrease suspending suture detachment. Those modifications included: (1) technique of needle passage to capture a maximum volume of urethropelvic fascia lateral to the bladder neck and urethra while avoiding injury to the bladder, (2) pubic bone fixation of the suspending suture using a small anchor developed for orthopedic use, and (3) a simple technique to limit tension of the suspending sutures. Procedures were outpatient in 60 percent of patients (93% of the last 27 patients). Seventy percent of patients did not require intermittent catheterization beyond the day when their indwelling catheter was removed. The postoperative success rate (absence of stress urinary incontinence) at one month was 100 percent. There were 4 failures on follow-up up to fifteen months. Urgency incontinence decreased from 59 percent preoperatively to 15 percent postoperatively. The complication of osteitis pubis was not noted. Patient rating of satisfaction postoperatively was high. These modifications constitute a safe alternative to procedures that effectively suspend the bladder neck. An assessment of any change in long-term efficacy as a result of these modifications will require continued follow-up.

Adult