Hemodynamic instability following an avulsion of the corona mortis artery secondary to a benign pubic ramus
Using that approach, the patient is placed in the supine position and an ultrasound transducer is introduced in the sagittal plane at the pubic region between the femoral vein and the pubic tubercle (Figures 1(b) and 2(c)) to visualize the superior pubic ramus
, thepectineus muscle, and theobturator externusmuscle(Figure 3(c)).
Peroperatively, the tumor appeared as oval, reddish brown, bony hard mass lying just over the cortex of the right pubic ramus
and not breaching the cortex.
Did the right pubic ramus
fracture happened in April related to minor trauma?
Cunningham and colleagues have suggested previously that an accessory cleft between the inferior pubic ramus
and the adductor longus tendon attachment reflects adductor avulsion at this site, which leads to adductor dysfunction and groin pain.
But the zone of highest von-Mises stress varied during gait from superior pubic ramus
for maximum load (Figure 3a) to central inferior ilium for minimum load (Figure 3b).
The dissection was continued and the arms of the mesh sling were dissected away from the posterior aspect of the pubic ramus
, down through the pubocervical fascia and, once free, the arms were both removed vaginally (Figure 3).
Their patient presented at the 32nd week of gestation with pain in the right leg and was diagnosed with Ewing's sarcoma of the pubic ramus
and patient was delivered by caesarean section at 36 weeks of gestation.
(See figure 2A.) The scissors are spread apart in the avascular lateral retroperitoneal space beneath the pubocervical fascia, and used to separate the fascia from the undersurface of the vagina to the pubic ramus
. This is repeated on the other side of the dissection.
A case is presented here who has been receiving alendronate treatment for 10 years and who has developed multipl fractures (femoral diaphysis, pubic ramus
, sacrum) with spontaneously or low energy trauma.
Figure 4 is an anteroposterior view of the pelvis, showing thickening of the cortex and bilateral ileopectineal lines (black arrow, the pelvic brim sign) and an irregular trabecular pattern within the right iliac and superior pubic ramus
. The fourth vertebral body periphery is sclerotic.