Advertisement

Steroid-related pubic symphysis diastasis in recreational horse riders

  • Félix Tomé-BermejoEmail author
  • Rafael Laredo-Rivero
  • Juan-Antonio Herrera-Molpeceres
  • Isidro Rivera-Vaquero
Case Report
  • 121 Downloads

Abstract

Wide diastasis of the pubic symphysis is generally secondary to high energy trauma. Slight separation of the pubic symphysis can be seen when pubic ligamentous laxity or consistency is altered in specific situations namely during vaginal delivery, and in elderly rheumatoid patients receiving long-term corticosteroid therapy after minor injuries. We present two cases of wide diastasis of the pubic symphysis following a sudden horse U-turn in two young recreational horse riders with a recent short-term steroid intake drug history, and a contemporary view of the physiopathology and definitive treatment for these injuries. Diastasis of the pubic symphysis resulting from a sudden horse U-turn, in horse riders with a drug history of recent short-term steroid intake has not been previously reported. We want to emphasise the risks of pubic symphysis fragility in patients with a recent medical history of steroids therapy.

Keywords

Symphysis pubis diastasis Pelvic ring disruption Steroids Horse riding Pubic symphysis fragility 

Notes

Conflict of interest statement

No funds were received in support of this study.

References

  1. 1.
    Price N, Ragoowansi R, Bircher M (1996) Pelvic ring diastasis and pseudo-diastasis in motorcycle pillion passengers. Injury 27:441–444CrossRefPubMedGoogle Scholar
  2. 2.
    Gänsslen A, Pohlemann T, Paul Ch, Lobenhoffer Ph, Tscherne H (1996) Epidemiology of pelvic ring injuries. Injury 27:13–20CrossRefGoogle Scholar
  3. 3.
    Kowalk DL, Perdue PS, Bourgeois FJ, Whitehill R (1996) Disruption of the symphysis pubis during vaginal delivery. A case report. J Bone Joint Surg (Am) 78-A:1746–1748Google Scholar
  4. 4.
    Tsukahara S, Momohara S, Ikari K, Murakoshi K, Mochizuki T, Kawamura K et al (2007) Disturbances of the symphysis pubis in rheumatoid arthritis: a report of two cases. Mod Rheumatol 17:344–347CrossRefPubMedGoogle Scholar
  5. 5.
    Kovacevic D, Rodeo SA (2008) Biological augmentation of rotator cuff tendon repair. Clin Orthop Relat Res 466(3):622–633CrossRefPubMedGoogle Scholar
  6. 6.
    Mulhall KJ, Khan Y, Ahmed A, O′Farrell D, Burke TE, Moloney M (2002) Diastasis of the pubis symphysis peculiar to horse riders: modern aspects of pelvic pommel injuries. Br J Sports Med 36:74–75CrossRefPubMedGoogle Scholar
  7. 7.
    Flynn M (1972) Disruption of symphysis pubis while horse riding: a report of two cases. Injury 4:357–359CrossRefGoogle Scholar
  8. 8.
    Seager S, Jui-Aenlle L, Faux N (1981) The urban cowboy syndrome. Ann Emerg Med 10:252–253CrossRefPubMedGoogle Scholar
  9. 9.
    Green RS, Maier R (2003) The urban cowboy syndrome revisited: case report. South Med J 96:1262–1264CrossRefPubMedGoogle Scholar
  10. 10.
    Stephen D (2003) Mini-symposium: trauma care. (ii) Management of high-energy pelvic fractures. Curr Orthop 17:335–345CrossRefGoogle Scholar
  11. 11.
    Kregor PJ, Rout MLC (1999) Unstable pelvic ring disruptions in unstable patients. Injury 30(Suppl 2):B19–B28CrossRefPubMedGoogle Scholar
  12. 12.
    Durkin A, Sagi HC, Durham R, Flint L (2006) Contemporary management of pelvic fractures. Am J Surg 192:211–223CrossRefPubMedGoogle Scholar
  13. 13.
    Kellam JF (1996) Mini-symposium: pelvic fractures. (iii) Definitive surgical management. Curr Orthop 10:18–24CrossRefGoogle Scholar
  14. 14.
    Goldstein A, Phillips T, Sclafani SJA et al (1986) Early open reduction and internal fixation of the disrupted pelvic ring. J Trauma 26:325–333CrossRefPubMedGoogle Scholar
  15. 15.
    Simonian PT, Rout MLC, Harrington RM, Tencer AF (1994) Box plate fixation of the symphysis pubis: biomechanical evaluation of a new technique. J Orthop Trauma 8:483–489PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Félix Tomé-Bermejo
    • 1
    • 2
    Email author
  • Rafael Laredo-Rivero
    • 1
  • Juan-Antonio Herrera-Molpeceres
    • 1
  • Isidro Rivera-Vaquero
    • 1
  1. 1.Orthopaedic and Trauma Surgery DepartmentHospital Virgen de la SaludToledoSpain
  2. 2.Alfredo Marqueríe, 5528034Spain

Personalised recommendations