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Symphysis pubis dysfunction (SPD), commonly known as pubic symphysis dysfunction or lightning crotch, [1] is a condition that causes excessive movement of the pubic symphysis, either anterior or lateral, as well as associated pain, possibly because of a misalignment of the pelvis.
The pubic symphysis is a nonsynovial amphiarthrodial joint. The width of the pubic symphysis at the front is 3–5 mm greater than its width at the back. This joint is connected by fibrocartilage and may contain a fluid-filled cavity; the center is avascular, possibly due to the nature of the compressive forces passing through this joint, which may lead to harmful vascular disease. [2]
Pubic symphysis diastasis (also known as diastasis symphysis pubis) is the separation of normally joined pubic bones, as in the dislocation of the bones, without a fracture that measures radiologically more than 10 mm. Separation of the symphysis pubis is a rare pathology associated with childbirth and has an incidence of 1 in 300 to 1 in 30,000 births.
The pubic symphysis has a fibrocartilage joint which may contain a fluid filled cavity and is avascular; it is supported by the superior and arcuate ligaments. The sacroiliac joints are synovial, but their movement is restricted throughout life and they are progressively obliterated by adhesions. The nature of the bony pelvic ring with its ...
To assess the degree of dysfunction, three measurements are taken into account. First, an anatomic landmark known as the pubococcygeal line must be determined, which is a straight line connecting the inferior margin of the pubic symphysis at the midline with the junction of the first and second coccygeal elements on a sagittal image.
The treatment of obstructed labour may require cesarean section or vacuum extraction with possible surgical opening of the symphysis pubis. [4] Caesarean section is an invasive method but is often the only method that will save the lives of both the mother and the infant. [18] Symphysiotomy is the surgical opening of the symphysis pubis.
These bones are the pubis, ilium and ischium. The interior surface of these pelvic bones and their projections and contours are used as attachment sites for the fascia, muscles, tendons and ligaments that support the vagina. These bones are then fuse and attach to the sacrum behind the vagina and anteriorly at the pubic symphysis. [3]
Symphysiotomy is a surgical procedure in which the cartilage of the pubic symphysis is divided to widen the pelvis allowing childbirth when there is a mechanical problem (obstructed labour). It is also known as pelviotomy [ 1 ] and synchondrotomy. [ 1 ]